Improving the efficiency of health care spending

Erlandsen, Espen

doi:10.1787/eco_studies-v2008-art2-en

Cited by 5 publications

(1 citation statement)

References 23 publications

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“…No consensus as to what drives efficiency in the hospital sector has been reached, mostly due to methodological differences (Hollingsworth ). The measurement of technical efficiency of hospitals is a cottage industry around the world, and we rely mostly on systematic reviews conducted at regular intervals (Hollingsworth, ; Erlandsen ; Hollingsworth and Peacock ; Rosko and Mutter ; O'Donnell and Nguyen ; Giancotti and Mauro ). A recent review of 200 studies conducted by O'Donnell and Nguyen () identified a number of data problems that severely limit the validity of conclusions, specifically a lack of consistent definitions of costs and measures of quality.…”

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confidence: 99%

The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada

Wang

Grignon

Perry

et al. 2018

Health Services Research

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confidence: 99%

The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada

Wang

Grignon

Perry

et al. 2018

Health Services Research

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Efficiency, effectiveness, equity (E3). Evaluating hospital performance in three dimensions

et al. 2013

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There are well-established frameworks for comparing the performance of health systems cross-nationally on multiple dimensions. A sub-set of such comprehensive schema is taken up by criteria specifically applied to health service delivery, including hospital performance. We focus on evaluating hospital performance, using the New Zealand public hospital sector over the period 2001-2009 as a pragmatic and illustrative case study for cross-national application. We apply a broad three-dimensional matrix--efficiency, effectiveness, equity--each based on two measures, and we undertake ranking comparisons of 35 hospitals. On the efficiency dimension--relative stay, day surgery--we find coefficients of variation of 10.8% and 8.5% respectively in the pooled data, and a slight trend towards a narrowing of inter-hospital variation over time. The correlation between these indicators is low (.20). For effectiveness--post-admission mortality, unplanned readmission--the coefficient of variation is generally higher (24.1% and 12.2%), and the trend is flat. The correlation is again low (.21). The equity dimension is assessed by quantifying the degree of ethnic and socio-economic variation for each hospital. The coefficient of variation is much higher--40.7-66.5% for ethnicity, 55.8-84.4% for socio-economic position--the trend over time is mixed, and the correlation is moderate (.41). On averaging the rank of hospitals across all measures it is evident that there is limited consistency across the three constituent dimensions. While it is possible to assess hospital performance across three dimensions using an illustrative set of standard measures derived from routine data, there appears to be little consistency in hospital rankings on these New Zealand data for the period 2001-2009. However, the methodology of using rankings derived from readily available data--possibly allied with multiple or composite indicator models--has potential for the cross-national comparison of hospital profiles, and assessments in three dimensions provide a more holistic and rounded account of performance.

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Behavior Analysis of Medical Institution and Medical Insurance Department under DRGs Payment Mode Based on Game Theory

马¹

2022

ORF

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Improving the efficiency of health care spending

Cited by 5 publications

References 23 publications

The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada

The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada

Efficiency, effectiveness, equity (E3). Evaluating hospital performance in three dimensions

Behavior Analysis of Medical Institution and Medical Insurance Department under DRGs Payment Mode Based on Game Theory

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