Quality and resource efficiency in hospital service provision: A geoadditive stochastic frontier analysis of stroke quality of care in Germany
Journal
PLOS ONE
ISSN
1932-6203
Type
journal article
Date Issued
2018-09
Author(s)
Research Team
https://www.alexandria.unisg.ch/persons/8635
Abstract (De)
We specify a Bayesian, geoadditive Stochastic Frontier Analysis (SFA) model to assess hospital performance along the dimensions of resources and quality of stroke care in German hospitals. With 1,100 annual observations and data from 2006 to 2013 and risk-adjusted patient volume as output, we introduce a production function that captures quality, resource inputs, hospital inefficiency determinants and spatial patterns of inefficiencies. With high relevance for hospital management and health system regulators, we identify performance improvement mechanisms by considering marginal effects for the average hospital. Specialization and certification can substantially reduce mortality. Regional and hospital-level concentration can improve quality and resource efficiency. Finally, our results demonstrate a trade-off between quality improvement and resource reduction and substantial regional variation in efficiency.
Language
English
HSG Classification
contribution to scientific community
Refereed
Yes
Publisher
PLOS
Volume
13
Number
9:e0203017
Subject(s)
Eprints ID
259574
File(s)![Thumbnail Image]()
open.access
Name
journal.pone.0203017.pdf
Size
11.06 MB
Format
Adobe PDF
Checksum (MD5)
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