Cost accounting and public reimbursement schemes in Spanish hospitals

Sánchez-Martínez, Fernando Ignacio; Abellán-Perpiñán, José-María; Martínez-Pérez, Jorge-Eduardo; Puig‐Junoy, Jaume

doi:10.1007/s10729-006-9089-x

Cited by 24 publications

(23 citation statements)

References 4 publications

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“…The extremely low ward costs reported for Italy are partly due to these having been included in overhead costs. Average provider reimbursement from the National Health Service or public health insurers ranged from h1771 to h9975; with a sample average of h6067 ðSTD AE 2404Þ: Provider reimbursement for Spain was not available, as hospitals in most Spanish regions receive retrospective budget payments that depend only partly on the number of cases treated (Sa´nchez-Martı´nez et al, 2006). Compared with the average cost of treatment, average reimbursement per country was greater than total costs for all countries except Poland.…”

Section: Descriptive Statisticsmentioning

confidence: 99%

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

Stargardt¹

2008

Health Econ.

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SUMMARYThis 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 h1290 (Hungary) to h8739 (The Netherlands), with a mean cost of h5043 ðSTD AE h2071Þ: 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 withincountry 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.

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Section: Descriptive Statisticsmentioning

confidence: 99%

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

Stargardt¹

2008

Health Econ.

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“…The DRG systems used in Hungary [5], England [6], and Italy [7] are also based on the HCFA system, while the DRG system used in Spain is based on the AP DRG system [8]. However, whereas Hungary (1993) and England (2003) have introduced modified versions of the HCFA system, Italy (1995) and Spain (1997) have fully adopted the HCFA system and the AP system, only slightly modifying the classification system for certain regions.…”

Section: Categorization Of Patient Classification Systemsmentioning

confidence: 99%

“…to account for differences in hospital structure. In England, average costs per DRG are adjusted by price differences among input factors (e.g., local wage level, rental fees), while France calculates average cost per DRG for groups of hospitals belonging to one of five types [4][5][6][7][8][9][10].…”

Section: Countrymentioning

confidence: 99%

Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries

Schreyögg

Stargardt

Tiemann

et al. 2006

Health Care Manage Sci

176

121

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Over the past 20 years, most European countries have introduced DRGs or similar grouping systems as instruments for hospital reimbursement. This paper compares and analyzes the methods used to determine prices for inpatient care within DRGs or similar grouping systems employed in nine EU member states (i.e., Denmark, France, Germany, Hungary, Italy, Tthe Netherlands, Poland, Spain and England). It categorizes the systems of patient classification used in these nine countries and compares them according to the three steps necessary in order to set prices: 1.) definition of a data sample, 2.) use of trimming methods and plausibility checks and 3.) definition of prices. It concludes with a discussion on the typical development path of DRG systems and the role of additional reimbursement components in this context.

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“…Reimbursement data for Spain were not available because most hospitals there have fixed budgets and receive their payments retrospectively. The one exception is the Catalonia region, where a prospective DRG-payment system is currently in place (Sanchez-Martinez et al, 2006).…”

Section: Descriptive Statisticsmentioning

confidence: 99%

Variations in hospitalisation costs for acute myocardial infarction – a comparison across Europe

Tiemann¹

2008

Health Econ.

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SUMMARYThe aim of this study was to determine whether between-country variations in hospital costs are larger than withincountry variations and, furthermore, to explore reasons for this variability. For this purpose, we chose the primary treatment of patients with acute myocardial infarction (AMI) as an episode of care. We obtained hospitalisation costs and reimbursement rates from 45 hospitals in nine different EU member states (i.e. Denmark, England, France, Germany, Hungary, Italy, Netherlands, Poland, and Spain) for the year 2005. To further analyse the variations in hospital costs, we employed a hierarchical random effects model based on treatment and hospital characteristics and using purchasing power parities (PPPs) as a proxy for country-specific price levels. The betweencountry standard error was estimated at h2473; whereas the within-country standard error was estimated at h1242: Our regression analysis showed that percutaneous coronary intervention was associated with significantly increased hospitals costs compared to other treatment strategies. We were able to distinguish between three groups of countries with different cost levels based on the number of hospitals that were able to provide these services (i.e. percutaneous transluminal coronary angioplasty (PTCA) with intracoronary stenting). Excluding Hungary, Poland, and Spain, where none of the participating hospitals were able to provide these procedures, the betweencountry standard error decreased to h1632; whereas the within-country standard error increased to h1416: Finally, we observed exogenous price-level effects between countries and within countries for hospitals located in urban areas.

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Cost accounting and public reimbursement schemes in Spanish hospitals

Cited by 24 publications

References 4 publications

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

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

Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries

Variations in hospitalisation costs for acute myocardial infarction – a comparison across Europe

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