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Health service costs in Europe: cost and reimbursement of primary hip replacement in nine countries

  • Tom Stargardt

    (Department of Health Care Management, Faculty of Economics and Management, Berlin University of Technology, Berlin, Germany)

This paper assesses variations in the cost of primary hip replacement between and within nine member states of the European Union (EU). It also compares the cost of service with public-payer reimbursements. To do so, data on cost and reimbursement were surveyed at the micro-level in 42 hospitals in Denmark, England, France, Germany, Hungary, Italy, The Netherlands, Poland, and Spain. The total cost of treatment ranged from €1290 (Hungary) to €8739 (The Netherlands), with a mean cost of €5043 (STD±€2071). The main cost drivers were found to be implants (34% of total cost on average) and ward costs (20.9% of total cost on average). A one-way random effects analysis of variance model indicated that 74.0% of variation was between and only 26% of variation was within countries. In a two-level random-intercept regression model, purchasing-power parities explained 79.4% of the explainable between-country variation, while the percentage of uncemented implants used and the number of beds explained 12.1 and 1.6% of explainable within-country variation, respectively. The large differences in cost and reimbursement between Poland, Hungary, and the other EU member states shows that primary total hip replacement is a highly relevant case for cross-border care. Copyright © 2008 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1328
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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): S1 ()
Pages: S9-S20

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Handle: RePEc:wly:hlthec:v:17:y:2008:i:s1:p:s9-s20
Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. 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.
  2. Adam, Taghreed & Evans, David B., 2006. "Determinants of variation in the cost of inpatient stays versus outpatient visits in hospitals: A multi-country analysis," Social Science & Medicine, Elsevier, vol. 63(7), pages 1700-1710, October.
  3. Adam Kozierkiewicz & Maciej Stamirski & Waldemar Stylo & Wojciech Trąbka, 2006. "The definition of prices for inpatient care in Poland in the absence of cost data," Health Care Management Science, Springer, vol. 9(3), pages 281-286, 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. Vitaliano, Donald F., 1987. "On the estimation of hospital cost functions," Journal of Health Economics, Elsevier, vol. 6(4), pages 305-318, December.
  6. Luigi Siciliani & Jeremy Hurst, 2003. "Explaining Waiting Times Variations for Elective Surgery Across OECD Countries," OECD Health Working Papers 7, OECD Publishing.
  7. 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.
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