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A micro-costing approach to estimating hospital costs for appendectomy in a Cross-European context

  • Jonas Schreyögg

This paper aims (a) to determine whether variations in the hospital costs of appendectomy in EU member states are larger within individual countries or between different countries and (b) to explore causes for variations in costs between hospitals and countries. To do so, hospitalisation costs and reimbursement rates for appendectomy were obtained from 54 hospitals in nine European member states based on 1786 cases using a standardised methodology. Regression analysis was performed using hospital characteristics, treatment characteristics, and purchasing power parities (PPP) as explanatory variables in a multilevel framework. The within-country standard error was estimated to €294 (27%), whereas the between-country standard error was €796 (73%). Excluding hospitals in Spain, Hungary, and Poland, which had significantly lower costs than hospitals in the other countries in our analysis, the within-country standard error was €331 (57%) and the between-country standard error dropped to €248 (43%). Regression results show that the treatment decision for open surgery was associated with significantly lower costs, whereas a greater number of beds and a higher staff per bed ratio were associated with significantly higher costs. PPP explained a major part of the between-country variance. Copyright © 2008 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1323
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): S1 ()
Pages: S59-S69

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Handle: RePEc:wly:hlthec:v:17:y:2008:i:s1:p:s59-s69
Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Edward Evans & Yuichi Imanaka & Miho Sekimoto & Tatsuro Ishizaki & Kenshi Hayashida & Haruhisa Fukuda & Eun-Hwan Oh, 2007. "Risk adjusted resource utilization for AMI patients treated in Japanese hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 16(4), pages 347-359.
  2. J. A. Hausman, 1976. "Specification Tests in Econometrics," Working papers 185, Massachusetts Institute of Technology (MIT), Department of Economics.
  3. Fernando Sánchez-Martínez & José-María Abellán-Perpiñán & Jorge-Eduardo Martínez-Pérez & Jaume Puig-Junoy, 2006. "Cost accounting and public reimbursement schemes in Spanish hospitals," Health Care Management Science, Springer, vol. 9(3), pages 225-232, August.
  4. Richard Grieve & Richard Nixon & Simon G. Thompson & Charles Normand, 2005. "Using multilevel models for assessing the variability of multinational resource use and cost data," Health Economics, John Wiley & Sons, Ltd., vol. 14(2), pages 185-196.
  5. Jonas Schreyögg & Tom Stargardt & Oliver Tiemann & Reinhard Busse, 2006. "Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries," Health Care Management Science, Springer, vol. 9(3), pages 215-223, August.
  6. Evans III, John H. & Hwang, Yuhchang & Nagarajan, Nandu J., 2001. "Management control and hospital cost reduction: additional evidence," Journal of Accounting and Public Policy, Elsevier, vol. 20(1), pages 73-88.
  7. Breyer, Friedrich, 1987. "The specification of a hospital cost function : A comment on the recent literature," Journal of Health Economics, Elsevier, vol. 6(2), pages 147-157, June.
  8. Sarah Wordsworth & Anne Ludbrook, 2005. "Comparing costing results in across country economic evaluations: the use of technology specific purchasing power parities," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 93-99.
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