Quality and resource efficiency in hospital service provision: A geoadditive stochastic frontier analysis of stroke quality of care in Germany

Abstract

We specify a Bayesian, geoadditive Stochastic Frontier Analysis (SFA) model to assess hospital performance along the dimensions of resources and quality of stroke care in German hospitals. With 1,100 annual observations and data from 2006 to 2013 and risk-adjusted patient volume as output, we introduce a production function that captures quality, resource inputs, hospital inefficiency determinants and spatial patterns of inefficiencies. With high relevance for hospital management and health system regulators, we identify performance improvement mechanisms by considering marginal effects for the average hospital. Specialization and certification can substantially reduce mortality. Regional and hospital-level concentration can improve quality and resource efficiency. Finally, our results demonstrate a trade-off between quality improvement and resource reduction and substantial regional variation in efficiency.

Rationale and design of individualized quality improvement based on the Computer Analysing system to improve Stroke management quality Evaluation (CASE): a multicenter historically controlled study

“…By providing the participating hospitals with improvement consultation, workshops, and webinars based on guidelines, GWTG-Stroke program achieved significant improvement of composite measure of care from 83.53 to 93.97% [25]. Data analysis from 2010 to 2013 in Germany showed that the mortality was reduced by up to 6.26 (63.7%) deaths per year, if the average hospital boosts its performance to an efficient treatment of stroke patients [26]. In CASE trial, the automated calculation of KPIs identifies the non-compliance of guideline-based care, which allows the clinicians to examine their cause and develop programs to decrease their frequency.…”

Rationale and design of individualized quality improvement based on the Computer Analysing system to improve Stroke management quality Evaluation (CASE): a multicentre historically controlled study

“…By providing the participating hospitals with improvement consultation, workshops, and webinars based on guidelines, GWTG-Stroke program achieved signi cant improvement of composite measure of care from 83.53% to 93.97% (25) . Data analysis from 2010 to 2013 in Germany showed that the mortality was reduced by up to 6.26 (63.7%) deaths per year, if the average hospital boosts its performance to an e cient treatment of stroke patients (26) . In CASE trial, the automated calculation of KPIs identi es the non-compliance of guideline-based care, which allows the clinicians to examine their cause and develop programs to decrease their frequency.…”

Analisis Tarif INA-CBGs Pasien Hipertensi Rawat Inap di Rumah Sakit Umum Daerah Panembahan Senopati

“…Rumah sakit harus mengoptimalkan hubungan antara biaya dan kualitas pelayanan kesehatan yang seimbang agar efisiensi dapat terjadi. 15 Salah satu upaya guna meningkatkan efisiensi ialah rumah sakit harus memiliki clinical pathway untuk setiap diagnosis penyakit sebagai sebuah acuan dalam memberikan pelayanan medis pada pasien. 16 Acuan pelayanan medis yang digunakan oleh RSUD Panembahan Senopati ialah Standar Pelayanan Medis (SPM), namun terdapat dua jenis penyakit yang tidak memiliki SPM tentang penatalaksanaan pengobatannya, yaitu hipertensi dan diabetes melitus.…”