International hospital productivity comparison: Experiences from the Nordic countries

Abstract

This article focuses on describing the methodological challenges intrinsic in international comparative studies of hospital productivity and how these challenges have been addressed within the context of hospital comparisons in the Nordic countries. The hospital sectors in the Nordic countries are suitable for international comparison as they exhibit similar structures in the organisation for hospital care, hold administrative data of good quality at the hospital level, apply a similar secondary patient classification system, and use similar definitions of operating costs. The results of a number of studies have suggested marked differences in hospital cost efficiency and hospital productivity across the Nordic countries and the Finnish hospitals have the highest estimates in all the analyses. Explanatory factors that were tested and seemed to be of limited importance included institutional, structural and technical. A factor that is yet to be included in the Nordic hospital productivity comparison is the quality of care. Patient-level data available from linkable national registers in each country enable the development of quality indicators and will be included in the forthcoming hospital productivity studies within the context of the EuroHOPE (European health care outcomes, performance and efficiency) project.

Decomposing the productivity differences between hospitals in the Nordic countries

“…International comparisons of productivity and efficiency of hospitals are few, primarily because of the difficulty of getting comparable data on output (Derveaux et al 2004;Linna et al 2006;Medin et al 2013;Mobley and Magnussen 1998;Steinmann et al 2004;Varabyova and Schreyögg 2013). Such analyses often find quite substantial differences in performance between countries.…”

Productivity benchmarks for operative service units

“…Unit D consists of several small operating units that are run independently. In general, the Nordic health care and social security systems are similar and thus our data should be suitable for general comparisons and benchmarking purposes .…”

Measuring the efficiency of medical tourism industry in EU member states

“…DEA analysis has been widely used in other economic sectors since 1957 by Farrell (1957) as organisations have struggled to improve productivity and efficiency. DEA has a long history with lots of important publications in measuring efficiency of hospitals and clinics (Caves et al, 1982;Lovell, 1996;Cook and Seiford, 2009;Charnes et al, 1978;Färe et al, 1994;Coelli et al, 2005;Coelli and Perelman, 1996;Hollingsworth et al, 1999;Färe et al, 1989;Halkos and Tzeremes, 2010;Ancarani et al, 2009;Maniadakis et al, 2007;Androutsou et al, 2011;Staat, 2006;Geitona et al, 2013;Pulina et al, 2010;Khushalani and Ozcan, 2017;Steinmann and Zweifel, 2003;Leleu et al, 2014;Samut and Cafrı, 2016;Moran and Jacobs, 2013;Linna et al, 2006;Varabyova and Schreyögg, 2013;Medina et al, 2013).…”