Variations in hospitalisation costs for acute myocardial infarction – a comparison across Europe

Abstract

SUMMARYThe aim of this study was to determine whether between-country variations in hospital costs are larger than withincountry variations and, furthermore, to explore reasons for this variability. For this purpose, we chose the primary treatment of patients with acute myocardial infarction (AMI) as an episode of care. We obtained hospitalisation costs and reimbursement rates from 45 hospitals in nine different EU member states (i.e. Denmark, England, France, Germany, Hungary, Italy, Netherlands, Poland, and Spain) for the year 2005. To further analyse the variations in hospital costs, we employed a hierarchical random effects model based on treatment and hospital characteristics and using purchasing power parities (PPPs) as a proxy for country-specific price levels. The betweencountry standard error was estimated at h2473; whereas the within-country standard error was estimated at h1242: Our regression analysis showed that percutaneous coronary intervention was associated with significantly increased hospitals costs compared to other treatment strategies. We were able to distinguish between three groups of countries with different cost levels based on the number of hospitals that were able to provide these services (i.e. percutaneous transluminal coronary angioplasty (PTCA) with intracoronary stenting). Excluding Hungary, Poland, and Spain, where none of the participating hospitals were able to provide these procedures, the betweencountry standard error decreased to h1632; whereas the within-country standard error increased to h1416: Finally, we observed exogenous price-level effects between countries and within countries for hospitals located in urban areas.

Variability in healthcare treatment costs amongst nine EU countries – results from theHealthBASKET project

“…The AMI vignette showed some remarkable variations as well. In the Netherlands, the 'price' for an AMI treatment was h8722; whereas in neighbouring Germany, it was 'only' h3114 (Tiemann, 2008).…”

Frequency and Outcome of Carotid Atheromatous Disease in Patients With Stroke in Pakistan

“…38 Fourth, there is a significant price variation of different inputs (physician fee, medicine and diagnostics, hospitalization) for health care in Pakistan compared to organization of economic cooperation for developed countries and even within developed countries. 39 All of these factor contribute to variation in the costs and effectiveness of treatment and diagnostics strategies across the regions and countries, eg, health expenditure in absolute terms is low, reflecting low ability to pay for health care by not only the government but also, more importantly, by private households. As such, based on our study results, we are not able to recommend generalizing the results of our study; however, we can advocate that American Heart Association guidelines for stroke management are not a sound evidence for practice in Pakistan for the reasons mentioned.…”

Expectations of Russian Medical Tourists on German Health Care Services: A Kano Model-Based Analysis

“…Earnings from foreign patients do not underlie annual budget constraints and may provide an advantage within a highly competitive hospital market. From a patient' perspective Germany offers a technologically advanced health care system with highly trained doctors, first class medical faculties and costs much below the same procedures in the US [1][2][3][4][5].…”

“…Within ten years a nine fold increase in Russian inpatients from 1181 to 11.000 in 2013 was observed [1][2][3][4][5]. Medical treatment in Germany has always been seen as a special privilege and dates back to the famous Russian writers Turgenev and Dostojewski who searched for cure in Baden-Baden and Travemünde [6].…”