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Costs and quality of hospitals in different health care systems: a multi‐level approach with propensity score matching

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  • Jonas Schreyögg
  • Tom Stargardt
  • Oliver Tiemann

Abstract

Cross-country comparisons of costs and quality between hospitals are often made at the macro level. The goal of this study was to explore methods to compare micro‐level data from hospitals in different health care systems. To do so, we developed a multi‐level framework in combination with a propensity score matching technique using similarly structured data for patients receiving treatment for acute myocardial infarction in German and US Veterans Health Administration hospitals. Our case study shows important differences in results between multi‐level regressions based on matched and unmatched samples. We conclude that propensity score matching techniques are an appropriate way to deal with the usual baseline imbalances across the samples from different countries. Multi‐level models are recommendable to consider the clustered structure of the data when patient‐level data from different hospitals and health care systems are compared. The results provide an important justification for exploring new ways in performing health system comparisons. Copyright (C) 2010 John Wiley & Sons, Ltd.

Suggested Citation

  • Jonas Schreyögg & Tom Stargardt & Oliver Tiemann, 2011. "Costs and quality of hospitals in different health care systems: a multi‐level approach with propensity score matching," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 85-100, January.
  • Handle: RePEc:wly:hlthec:v:20:y:2011:i:1:p:85-100
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    File URL: http://hdl.handle.net/10.1002/hec.1568
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    Citations

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    Cited by:

    1. Stefan Voigt, 2016. "Determinants of judicial efficiency: a survey," European Journal of Law and Economics, Springer, vol. 42(2), pages 183-208, October.
    2. Oliver Tiemann & Jonas Schreyögg, 2012. "Changes in hospital efficiency after privatization," Health Care Management Science, Springer, vol. 15(4), pages 310-326, December.
    3. Tom Stargardt & Jonas Schreyögg & Ivan Kondofersky, 2014. "Measuring The Relationship Between Costs And Outcomes: The Example Of Acute Myocardial Infarction In German Hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 23(6), pages 653-669, June.
    4. Häkkinen, Unto & Iversen, Tor & Peltola, Mikko & Seppälä, Timo T. & Malmivaara, Antti & Belicza, Éva & Fattore, Giovanni & Numerato, Dino & Heijink, Richard & Medin, Emma & Rehnberg, Clas, 2013. "Health care performance comparison using a disease-based approach: The EuroHOPE project," Health Policy, Elsevier, vol. 112(1), pages 100-109.
    5. Stargardt, Tom & Schreyögg, Jonas, 2012. "A framework to evaluate the effects of small area variations in healthcare infrastructure on diagnostics and patient outcomes of rare diseases based on administrative data," Health Policy, Elsevier, vol. 105(2), pages 110-118.
    6. Helmut Herwartz & Christoph Strumann, 2012. "On the effect of prospective payment on local hospital competition in Germany," Health Care Management Science, Springer, vol. 15(1), pages 48-62, March.
    7. Laura Haas & Tom Stargardt & Jonas Schreyoegg, 2012. "Cost-effectiveness of open versus laparoscopic appendectomy: a multilevel approach with propensity score matching," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(5), pages 549-560, October.

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