How to measure French hospital production?[La production hospitalière : Comment la mesurer ?]

How can hospital output be measured? One simple indicator is the number of admissions. However, patients requiring urgent care or those with multiple conditions do not require the same level of resources as patients admitted for elective procedures without associated comorbidities. Over the period 2013–2019, we propose comparing differences in outcomes based on the measure of output used, whether costs or reimbursement rates. Descriptive statistics reveal a segmentation of the market. Public hospitals treat patients with severe conditions and provide inpatient care, whilst private hospitals have shifted towards outpatient care (less than 12 hours' hospitalisation). Comparing healthcare output results based on gross costs and adjusted costs reveals that differences in the management of healthcare staff impact sectoral differences in output calculated by costs. Comparing costs and reimbursed rates highlights that sectoral differences in output are due to differences in patient care (outpatient versus overnight stays) and differences in severity. Our findings on the measurement of output provide a comparison of the differences in results across different approaches to measuring output. Introducing a longitudinal dimension allows us to account for the differences observed over time.