Examining cost variation across hospital departments--a two-stage multi-level approach using patient-level data

Laudicella, M., Olsen, K. R. & Street, A. (2010). Examining cost variation across hospital departments--a two-stage multi-level approach using patient-level data. Social Science & Medicine, 71(10), pp. 1872-1881. doi: 10.1016/j.socscimed.2010.06.049

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Abstract

Studies of hospital efficiency seldom lead to changes in practice, partly because recommendations are unspecific or results are not seen as robust. We describe a method to compare hospital costs that utilises patient-level data. We perform a two-stage analysis in which we first consider factors that explain costs among patients and then across hospital departments. We illustrate our approach by examining the costs and characteristics of almost one million patients admitted to 136 English NHS hospital obstetrics departments in 2005/2006. We identify those departments with significantly higher costs that need to take action.

Item Type: Article
Additional Information: NOTICE: this is the author’s version of a work that was accepted for publication in Social Science & Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Social Science & Medicine Volume 71, Issue 10, November 2010, Pages 1872–1881, http://dx.doi.org/10.1016/j.socscimed.2010.06.049.
Uncontrolled Keywords: UK; Hospital efficiency; Multi-level modelling; Prospective payment; Obstetrics; Hospital costs
Subjects: R Medicine > RA Public aspects of medicine
Divisions: School of Health Sciences > Healthcare Research Unit
Related URLs:
URI: http://openaccess.city.ac.uk/id/eprint/6838

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