Hospital heterogeneity: what drives the quality of health care

Manhal Ali (), Reza Salehnejad () and Mohaimen Mansur ()
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Manhal Ali: University of Manchester
Reza Salehnejad: University of Manchester
Mohaimen Mansur: University of Manchester

The European Journal of Health Economics, 2018, vol. 19, issue 3, No 7, 385-408

Abstract: Abstract A major feature of health care systems is substantial variation in health care quality across hospitals. The quality of stroke care widely varies across NHS hospitals. We investigate factors that may explain variations in health care quality using measures of quality of stroke care. We combine NHS trust data from the National Sentinel Stroke Audit with other data sets from the Office for National Statistics, NHS and census data to capture hospitals’ human and physical assets and organisational characteristics. We employ a class of non-parametric methods to explore the complex structure of the data and a set of correlated random effects models to identify key determinants of the quality of stroke care. The organisational quality of the process of stroke care appears as a fundamental driver of clinical quality of stroke care. There are rich complementarities amongst drivers of quality of stroke care. The findings strengthen previous research on managerial and organisational determinants of health care quality.

Keywords: Health care quality; Stroke; NHS; Machine learning; Regression trees; Panel data; Prediction; Mixed effects model (search for similar items in EconPapers)
JEL-codes: C23 C40 C52 C53 D23 I10 L22 (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (3)

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DOI: 10.1007/s10198-017-0891-9

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