Meggiolaro, Angela; Blankart, Carl Rudolf; Stargardt, Tom; Schreyögg, Jonas (2023). An econometric approach to aggregating multiple cardiovascular outcomes in German hospitals. European journal of health economics, 24(5), pp. 785-802. Springer 10.1007/s10198-022-01509-y
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2022_EJHE_Meggiolaro_-_An_econometric_approach_to_aggregating_multiple_cardiovascular_outcomes.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (1MB) | Preview |
Objective
Development of an aggregate quality index to evaluate hospital performance in cardiovascular events treatment.
Methods
We applied a two-stage regression approach using an accelerated failure time model based on variance weights to estimate hospital quality over four cardiovascular interventions: elective coronary bypass graft, elective cardiac resynchronization therapy, and emergency treatment for acute myocardial infarction. Mortality and readmissions were used as outcomes. For the estimation we used data from a statutory health insurer in Germany from 2005 to 2016.
Results
The precision-based weights calculated in the first stage were higher for mortality than for readmissions. In general, teaching hospitals performed better in our ranking of hospital quality compared to non-teaching hospitals, as did private not-for-profit hospitals compared to hospitals with public or private for-profit ownership.
Discussion
The proposed approach is a new method to aggregate single hospital quality outcomes using objective, precision-based weights. Likelihood-based accelerated failure time models make use of existing data more efficiently compared to widely used models relying on dichotomized data. The main advantage of the variance-based weights approach is that the extent to which an indicator contributes to the aggregate index depends on the amount of its variance.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Faculty Institutions > sitem Center for Translational Medicine and Biomedical Entrepreneurship > Healthcare Regulation and Management 04 Faculty of Medicine > Faculty Institutions > sitem Center for Translational Medicine and Biomedical Entrepreneurship 11 Centers of Competence > KPM Center for Public Management |
UniBE Contributor: |
Blankart, Rudolf |
Subjects: |
300 Social sciences, sociology & anthropology > 350 Public administration & military science 300 Social sciences, sociology & anthropology > 330 Economics |
ISSN: |
1618-7598 |
Publisher: |
Springer |
Funders: |
Organisations 721402 not found. |
Language: |
English |
Submitter: |
Carl Rudolf Berchtold Blankart |
Date Deposited: |
23 Sep 2022 16:18 |
Last Modified: |
20 May 2023 00:11 |
Publisher DOI: |
10.1007/s10198-022-01509-y |
PubMed ID: |
36112269 |
BORIS DOI: |
10.48350/173219 |
URI: |
https://boris.unibe.ch/id/eprint/173219 |
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