Mortality outcomes in hospitals with public, private not-for-profit and private for-profit ownership in Chile 2001-2010

Cid, Camilo; Herrera, Cristian A; Prieto, Lorena; Oyarzún, Fernando

doi:10.1093/heapol/czu143

Cited by 15 publications

(11 citation statements)

References 7 publications

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“…In the Netherlands, out of 2,363,332 hospital admissions in the years 2005-2007, 3.85% ended with death [9]. In an analysis of hospital data from Chile for the period 2001-2010 covering 16,205,314 discharges, death was reported in 3.5% of cases [6]. In our previous study we assessed in-hospital mortality in patients undergoing surgical treatment on the basis of a 4-year observation of the same general population as in the current study and found that the mean surgery-related in-hospital yearly mortality was approximately 1% [23], thus four times lower than the one for non-surgery-related deaths reported here.…”

Section: Discussionmentioning

confidence: 99%

“…There are also studies assessing mortality in specific hospital departments, mostly intensive care units [3,4]. Other studies, when analyzing large and very large populations [5][6][7][8][9][10][11], did not distinguish between surgical and non-surgical deaths or showed only surgical mortality [12]. However, there are no studies assessing non-surgical mortality in a large population (of any country) across all diseases or disease groups.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between age and in-hospital mortality during 15,345,025 non-surgical hospitalizations

et al. 2021

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IntroductionMortality, whether in or out of hospital, increases with age. However, studies evaluating in-hospital mortality in large populations did not distinguish between surgical and non-surgical causes of death, either in young or in elderly patients. The aim of the study was to assess in-hospital non-surgical mortality in a large group of patients, with a special focus on the elderly.Material and methodsData from the database of the Polish National Health Fund (NHF) regarding hospitalizations of adult (≥ 18 years) patients not related to surgical procedures in the years 2009–2013 were used to assess in-hospital mortality.Results15,345,025 hospitalizations were assessed. The mean in-hospital non-surgery-related mortality rate was 3.96 ±0.17%, and increased from 3.79% to 4.2% between 2009 and 2013. The mean odds ratio for in-hospital death increased with the age of patients, reaching a 229-fold higher rate in the ≥ 95 years age group as compared to the 18–24 age group. The highest mean mortality was associated with respiratory diseases (6.91 ±0.20%), followed by heart and vascular diseases, nervous system diseases, as well as combined gastrointestinal tract, liver, biliary tract, pancreas and spleen diseases (5.65 ±0.27%, 5.46 ±0.05% and 4.01 ±0.13%, respectively).ConclusionsThe in-hospital non-surgery-related mortality rate was approximately 4%. It significantly increased with age and, regardless of age, was highest in patients suffering from respiratory diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationship between age and in-hospital mortality during 15,345,025 non-surgical hospitalizations

et al. 2021

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“…In the case of Chile, a study shows differences in mortality by type of hospital ownership, which in turn is related to an individual’s socioeconomic characteristics, though the latter are not explicitly incorporated in the estimations. 24 Other evidence points to a non-linear relationship between income and self-perceived oral health. 25 There is also some evidence on healthcare utilisation (but not LOS), with higher utilisation for general practitioners and physician visits among richer adults, while emergency room visits and hospitalisations are concentrated among lower-income quintiles.…”

Section: Discussionmentioning

confidence: 99%

Examining the relationship between poverty and length of stay: a repeated cross-sectional study of paediatric hospitalisations in Chile

Borrescio-Higa

Santistevan

2020

BMJ Open

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ObjectiveTo measure poverty-based disparities in inpatient length of stay for paediatric hospitalisations. In particular, this paper examines the relationship between municipality level poverty rates and length of stay, accounting for individual level characteristics.DesignWe use patient discharge data to conduct a repeated cross-sectional study of the totality of paediatric hospitalisations in 15 regions of Chile, in the years 2011, 2013, 2015 and 2017.SettingAll hospital discharges in 15 regions of Chile.Participants1 033 222 discharges for children under the age of 15, between 2011 and 2017.Outcome measuresLength of stay (LOS); LOS by type of insurance and type of hospital; hospitalisation rates; municipality-level average LOS.ResultsWe find that municipality level poverty rates are a significant predictor of LOS, even after controlling for individual and area level characteristics, including type of insurance. Children from municipalities in the poorest quintile have a LOS that is 14% shorter as compared with children from municipalities in the richest quintile. This relationship is stronger for publicly insured children: the decrease in LOS associated with the same poverty change is of 22%.ConclusionsThis paper shows that there is an association between municipality-level poverty rates and length of stay for paediatric hospitalisations in Chile. For the vast majority of the sample, and after controlling for individual level characteristics, an increase in the municipality level poverty rate is associated with a decrease in the length of stay. Further, there is a non-linearity in the relationship, where at the highest poverty rates, poverty and LOS are positively associated. These findings are robust after controlling for type of hospital (public vs private), type of insurance (public vs private), type of diagnosis, as well as year and region fixed effects.

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“…Dieser Unterschied resultiert wohl aus der Umstellung des Finanzierungssystems in 2003 und die Auswirkungen auf interne Prozesse. Schließlich kamen aktuelle Studien aus Österreich [22], Niederlande [23], Chile [24], Spanien [25], Schweiz [26] und Norwegen [27] auch zu unterschiedlichen Ergebnissen, weshalb keine generalisierten Aussagen hinsichtlich einer Effizienzsteigerung nach einem Trägerwechsel getroffen werden können, obwohl diese bei einer Privatisierung erhofft wird. In ▶ Tab.…”

Section: Mögliche Gründe Für Privatisierungen In Deutschland Mit Besounclassified

Erfolg der Privatisierung von Krankenhäusern – Eine Einschätzung aus der Sicht ehemaliger öffentlicher Krankenhausträger

Negele

Ott

Wellisch

2017

Gesundh ökon Qual manag

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Zusammenfassung Zielsetzung In den letzten Jahren konnte eine Steigerung der Anzahl privater Krankenhäuser und Betten festgestellt werden. Die Probleme der Investitionsfinanzierung deutscher Krankenhäuser in Kombination mit verstärkenden Faktoren wie der Einführung der DRGs, aber auch die Erwartung einer höheren Effizienz nach der Privatisierung einer Klinik können als Hauptgründe bei Privatisierungsentscheidungen genannt werden. Es soll untersucht werden, wie ehemalige öffentliche Krankenhausträger den Erfolg der Privatisierung einschätzen. Methodik Alle 99 identifizierten ehemaligen öffentlichen Träger, die ihr Krankenhaus in den Jahren 2003–2013 an einen privaten Eigentümer verkauft hatten, wurden hinsichtlich ihrer Einschätzung von Zielen sowie Befürchtungen vor und nach der Privatisierung anonym und schriftlich befragt. Ergebnisse und Schlussfolgerung Zusammenfassend lässt sich feststellen, dass bei einer ausreichenden Finanzierung der Krankenhäuser aus Krankenkassenbeiträgen (Betriebsmittel) und Ländermittel (Investitionskosten) der Privatisierungsdruck rapide sinken würde. Wenn jedoch privatisiert wurde, hatte dies aus Sicht der ehemaligen Träger weder einen negativen Einfluss auf die medizinische Versorgung in der Region, noch auf die Qualität der medizinischen Behandlung und auf den Umgang mit den Mitarbeitern. Die Einschätzungen der ehemaligen Träger weisen eine statistisch überprüfte Übereinstimmung auf. Die mit einer Privatisierung verbundenen Erwartungen und Ziele werden prinzipiell als erfüllt wahrgenommen.

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Mortality outcomes in hospitals with public, private not-for-profit and private for-profit ownership in Chile 2001-2010

Cited by 15 publications

References 7 publications

Relationship between age and in-hospital mortality during 15,345,025 non-surgical hospitalizations

Relationship between age and in-hospital mortality during 15,345,025 non-surgical hospitalizations

Examining the relationship between poverty and length of stay: a repeated cross-sectional study of paediatric hospitalisations in Chile

Erfolg der Privatisierung von Krankenhäusern – Eine Einschätzung aus der Sicht ehemaliger öffentlicher Krankenhausträger

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