dc.contributor.author | Kittelsen, Sverre A.C. | |
dc.contributor.author | Anthun, Kjartan Sarheim | |
dc.contributor.author | Goude, Fanny | |
dc.contributor.author | Huitfeldt, Ingrid Marie Schaumburg | |
dc.contributor.author | Häkkinen, Unto | |
dc.contributor.author | Kruse, Marie | |
dc.contributor.author | Medin, Emma | |
dc.contributor.author | Rehnberg, Clas | |
dc.contributor.author | Rättö, Hanna | |
dc.date.accessioned | 2018-03-21T09:07:10Z | |
dc.date.available | 2018-03-21T09:07:10Z | |
dc.date.created | 2016-01-14T11:12:08Z | |
dc.date.issued | 2015 | |
dc.identifier.citation | Health Economics. 2015, 24 140-163. | nb_NO |
dc.identifier.issn | 1057-9230 | |
dc.identifier.uri | http://hdl.handle.net/11250/2491399 | |
dc.description.abstract | This article develops and analyzes patient register-based measures of quality for the major Nordic countries. Previous studies show that Finnish hospitals have significantly higher average productivity than hospitals in Sweden, Denmark, and Norway and also a substantial variation within each country. This paper examines whether quality differences can form part of the explanation and attempts to uncover quality–cost trade-offs. Data on costs and discharges in each diagnosis-related group for 160 acute hospitals in 2008–2009 were collected. Patient register-based measures of quality such as readmissions, mortality (in hospital or outside), and patient safety indices were developed and case-mix adjusted. Productivity is estimated using bootstrapped data envelopment analysis. Results indicate that case-mix adjustment is important, and there are significant differences in the case-mix adjusted performance measures as well as in productivity both at the national and hospital levels. For most quality indicators, the performance measures reveal room for improvement. There is a weak but statistical significant trade-off between productivity and inpatient readmissions within 30 days but a tendency that hospitals with high 30-day mortality also have higher costs. Hence, no clear cost–quality trade-off pattern was discovered. Patient registers can be used and developed to improve future quality and cost comparisons. Copyright © 2015 John Wiley & Sons, Ltd. | nb_NO |
dc.language.iso | eng | nb_NO |
dc.publisher | Wiley | nb_NO |
dc.relation.uri | http://onlinelibrary.wiley.com/doi/10.1002/hec.3260/epdf | |
dc.title | Costs and quality at the hospital level in the nordic countries | nb_NO |
dc.type | Journal article | nb_NO |
dc.type | Peer reviewed | nb_NO |
dc.description.version | publishedVersion | nb_NO |
dc.source.pagenumber | 140-163 | nb_NO |
dc.source.volume | 24 | nb_NO |
dc.source.journal | Health Economics | nb_NO |
dc.identifier.doi | 10.1002/hec.3260 | |
dc.identifier.cristin | 1312918 | |
dc.relation.project | EU/241721 | nb_NO |
dc.relation.project | Norges forskningsråd: 214338 | nb_NO |
dc.description.localcode | Published by Wiley. Open access. | nb_NO |
cristin.unitcode | 194,65,20,0 | |
cristin.unitname | Institutt for samfunnsmedisin og sykepleie | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |