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dc.contributor.authorKittelsen, Sverre A.C.
dc.contributor.authorAnthun, Kjartan Sarheim
dc.contributor.authorGoude, Fanny
dc.contributor.authorHuitfeldt, Ingrid Marie Schaumburg
dc.contributor.authorHäkkinen, Unto
dc.contributor.authorKruse, Marie
dc.contributor.authorMedin, Emma
dc.contributor.authorRehnberg, Clas
dc.contributor.authorRättö, Hanna
dc.date.accessioned2018-03-21T09:07:10Z
dc.date.available2018-03-21T09:07:10Z
dc.date.created2016-01-14T11:12:08Z
dc.date.issued2015
dc.identifier.citationHealth Economics. 2015, 24 140-163.nb_NO
dc.identifier.issn1057-9230
dc.identifier.urihttp://hdl.handle.net/11250/2491399
dc.description.abstractThis 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.isoengnb_NO
dc.publisherWileynb_NO
dc.relation.urihttp://onlinelibrary.wiley.com/doi/10.1002/hec.3260/epdf
dc.titleCosts and quality at the hospital level in the nordic countriesnb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionpublishedVersionnb_NO
dc.source.pagenumber140-163nb_NO
dc.source.volume24nb_NO
dc.source.journalHealth Economicsnb_NO
dc.identifier.doi10.1002/hec.3260
dc.identifier.cristin1312918
dc.relation.projectEU/241721nb_NO
dc.relation.projectNorges forskningsråd: 214338nb_NO
dc.description.localcodePublished by Wiley. Open access.nb_NO
cristin.unitcode194,65,20,0
cristin.unitnameInstitutt for samfunnsmedisin og sykepleie
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2


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