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Differences in Length of Stay between Public Hospitals, Treatment Centres and Private Providers: Selection or Efficiency?

  • Luigi Siciliani

    (Department of Economics and Related Studies, and Centre for Health Economics, University of York; and Centre for Economic Policy Research, London)

  • Peter Sivey

    ()

    (Melbourne Institute of Applied Economic and Social Research, The University of Melborne)

  • Andrew Street

    (Centre for Health Economics, University of York)

We investigate differences in patients’ length of stay between National Health Service (NHS) public hospitals, public treatment centres and private treatment centres that provide elective (non-emergency) hip replacement to publicly-funded patients. We find that private treatment centres and public treatment centres have on average respectively 40% and 18% shorter length of stay compared to NHS public hospitals, even after controlling for differences in age, gender, number and type of diagnosis, deprivation and geographical variation. We therefore interpret such differences as due to efficiency as opposed to selection (treatment of less complex cases). Quantile regression suggests that the proportionate differences between different provider types are larger at the higher conditional quantiles of length of stay compared to the lower ones.

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Paper provided by Melbourne Institute of Applied Economic and Social Research, The University of Melbourne in its series Melbourne Institute Working Paper Series with number wp2011n06.

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Length: 16 pages
Date of creation: Mar 2011
Date of revision:
Handle: RePEc:iae:iaewps:wp2011n06
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Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Victoria 3010 Australia

Phone: +61 3 8344 2100
Fax: +61 3 8344 2111
Web page: http://www.melbourneinstitute.com/
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  1. Annika Herr, 2008. "Cost and technical efficiency of German hospitals: does ownership matter?," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1057-1071.
  2. Lien, Hsien-Ming & Chou, Shin-Yi & Liu, Jin-Tan, 2008. "Hospital ownership and performance: Evidence from stroke and cardiac treatment in Taiwan," Journal of Health Economics, Elsevier, vol. 27(5), pages 1208-1223, September.
  3. Paul H. Jensen & Elizabeth Webster & Julia Witt, 2009. "Hospital type and patient outcomes: an empirical examination using AMI readmission and mortality records," Health Economics, John Wiley & Sons, Ltd., vol. 18(12), pages 1440-1460.
  4. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128.
  5. Street, Andrew & Sivey, Peter & Mason, Anne & Miraldo, Marisa & Siciliani, Luigi, 2010. "Are English treatment centres treating less complex patients?," Health Policy, Elsevier, vol. 94(2), pages 150-157, February.
  6. Gian Paolo Barbetta & Gilberto Turati & Angelo Zago, 2004. "Behavioral Differences Between Public and Private Not-For-Profit Hospitals in the Italian National Health Service," Working Papers 12/2004, University of Verona, Department of Economics.
  7. Karen Eggleston & Yu-Chu Shen & Joseph Lau & Christopher H. Schmid & Jia Chan, 2008. "Hospital ownership and quality of care: what explains the different results in the literature?," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1345-1362.
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