Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis

Abstract

This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.

Publications by Scandinavian university Departments of Anaesthesiology from 2001 to 2015

“…In Scandinavian countries, the gross domestic expenditure on reseach and development (GERD) is fairly similar ranging from 2% in Norway to 3% in Sweden, namely of gross domestic product (GDP) in 2015 . Clinical research in Scandinavia is largely funded by the governments . In 2011 Medin et al evaluated the cost efficiency of university hospitals in Denmark, Finland, Norway and Sweden.…”

Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit

“…Medin et al (2011), in a study where they compared hospital efficiency, performed an international efficiency comparison among four Nordic countries and used DEA in the first stage and, then, OLS regression analysis in the second. Pelone et al (2012), measured the technical efficiency of general practice across 20 regions of Italy first Analysis of the Efficiency Determinants of Health Systems… by using DEA, and then identified the contextual variables that affect such efficiency using regression analysis.…”

Coordination pays off: a comparison of two models for organizing hip fracture care, outcomes and costs

“…In Sweden, the NordDRG version of the DRG patient classification system (Fetter, ; http://www.socialstyrelsen.se/EDP, ) is used to calculate the cost of in‐hospital services. Cost weights are calculated for each NordDRG patient group based on a national sample of hospital cost data, which includes direct costs as well as internally allocated costs (Medin et al ., ). The purchaser reimburses hospitals for discharged patients as the cost weight of the specific NordDRG group times the hospital's average cost per patient.…”