| Titre : | Truly inefficient or providing better quality of care? Analysing the relationship between risk-adjusted hospital costs and patients? health outcomes. |
| Titre original: | Les hôpitaux sont ils vraiment inefficaces ou fournissent-ils des soins de meilleure qualité ? Analyse de la relation entre les coûts hospitaliers ajustés au risque et les résultats pour la santé des patients. |
| Titre de série : | CHE Research Paper, 68 |
| Auteurs : | N. GUTACKER ; C. BOJKE ; S. DAIDONE ; University of York. Centre for Health Economics. (C.H.E.). York. GBR |
| Type de document : | Document de travail |
| Editeur : | York : University of York, 2011 |
| Format : | 21p., tabl., fig. |
| Note générale : | Référence : réf. bibl. |
| Langues: | Anglais |
| Catégories : |
[BDSP5] Economie santé > Dépense santé > Dépense hospitalière [BDSP5] Etablissement sanitaire > Structure curative > Hôpital [BDSP5] Etudes méthodes et statistiques [NI] > Méthodologie > Evaluation > Efficience [BDSP5] Etudes méthodes et statistiques [NI] > Méthodologie > Evaluation > Performance [BDSP5] Géographie politique > Monde > Europe > Iles Britanniques > Royaume Uni [BDSP5] Information sanitaire > Etat santé [BDSP5] Sciences économiques > Concept économique > RCB > Analyse coût efficacité [BDSP5] Sciences éducation > Pédagogie > Evaluation des connaissances > Autoévaluation [BDSP5] Soins > Qualité soins [BDSP5] Thérapeutique > Thérapeutique chirurgicale > Intervention chirurgicale |
| Résumé : | Accounting for variation in the quality of care is a major challenge for the assessment of hospital cost performance. Because data on patients? health improvement are generally not available, existing studies have resorted to inherently incomplete outcome measures such as mortality or re-admission rates. This opens up the possibility that providers of high quality care are falsely deemed inefficient and vice versa. This study makes use of a novel dataset of routinely collected patient-reported outcomes measures (PROMs) to i) assess the degree to which cost variation is associated with variation in patients? health gain and ii) explore how far judgement about hospital cost performance changes when health outcomes are accounted for. We use multilevel modelling to address the clustering of patients in providers and isolate unexplained cost variation. Our results provide some evidence of a U-shaped relationship between risk-adjusted costs and outcomes for hip replacement surgery. For the other three investigated procedures, the estimated relationship is sensitive to the choice of PROM instrument. We do not observe substantial changes in estimates of cost performance when outcomes are explicitly accounted for. |
| En ligne : | http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP68_Relationship_between_risk-adjusted_hospital_costs_and_health_outcomes.pdf |
Exemplaires (1)
| Code-barres | Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|---|
| 0062553 | P149/6 | Document de travail | Documentation IRDES | P : périodiques | Disponible |