Exploring the relationship between costs and quality - Does the joint evaluation of costs and quality alter the ranking of Danish hospital departments?

Hvenegaard Anne (), Jacob Arendt, Dorte Gyrd-Hansen () and Andrew Street
Additional contact information
Hvenegaard Anne: Danish Institute for Health Services Research

No 2009:6, DaCHE discussion papers from University of Southern Denmark, Dache - Danish Centre for Health Economics

Abstract: Objective: The purpose is to assess whether the joint evaluation of costs and quality affects the ranking of hospital departments relative to performance based on cost performance alone. Methods: Using patient level data, in which 3,754 patients across six vascular departments are pooled we estimate fixed effect models for costs (linear) and quality (logistic). We consider two quality measures; mortality and wound complications. To assess whether the joint evaluation of costs and quality affects the ranking of departments, we construct joint confidence regions for each pair of departmental effects for costs and quality by using a bootstrap method and rank departments according to their costeffectiveness ratio. Results: The association between cost and quality differs depending on how which quality is measured. Lower costs tend to associate with higher mortality, implying a cost-quality trade-off. In contrast there is no clear association between costs and wound complications among vascular departments. Conclusions: Compared to benchmarking of departments based solely on their costs, we show that the ranking of departments may be altered considerably when quality is taken into account. Consequently, it is important to have a well-rounded view of departmental objectives when undertaking performance evaluation.

Keywords: Hospital costs; efficiency; quality; cost-effectiveness (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
Pages: 22 pages
Date: 2010-06-25
Note: Download:http://www.sdu.dk/~/media/Files/Om_SDU/Centre/c_ist_sundoke/Forskningsdokumenter/publications/Working%20papers/20096.ashx
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

Downloads: (external link)
https://www.sdu.dk/-/media/files/om_sdu/centre/cohere/working+papers/20096.pdf Full text (application/pdf)

Related works:
Journal Article: Exploring the relationship between costs and quality: Does the joint evaluation of costs and quality alter the ranking of Danish hospital departments? (2011)
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hhs:sduhec:2009_006

Access Statistics for this paper

More papers in DaCHE discussion papers from University of Southern Denmark, Dache - Danish Centre for Health Economics DaCHE - Danish Centre for Health Economics, Institut for Sundhedstjenesteforskning, Syddansk Universitet, J.B. Winsløws Vej 9B, 2. sal, DK-5000 Odense, Denmark. Contact information at EDIRC.
Bibliographic data for series maintained by Christian Volmar Skovsgaard ().