Volume-outcome and its impact on US health care markets:
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Abschlussarbeit Buch |
| Sprache: | English |
| Veröffentlicht: |
Baden-Baden
Nomos-Verl.-Ges.
2006
|
| Ausgabe: | 1. Aufl. |
| Schriftenreihe: | Gesundheitsökonomische Beiträge
50 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | 246 S. Ill., graph. Darst., Kt. |
| ISBN: | 9783832921699 3832921699 |
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| 245 | 1 | 0 | |a Volume-outcome and its impact on US health care markets |c by Harald Seider |
| 250 | |a 1. Aufl. | ||
| 264 | 1 | |a Baden-Baden |b Nomos-Verl.-Ges. |c 2006 | |
| 300 | |a 246 S. |b Ill., graph. Darst., Kt. | ||
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| 502 | |a Zugl.: Augsburg, Univ., Diss., 2004 | ||
| 650 | 4 | |a Mathematisches Modell | |
| 650 | 4 | |a Coronary artery bypass |x Economic aspects |z United States | |
| 650 | 4 | |a Economies of scale |z United States | |
| 650 | 4 | |a Health Services |x utilization |z United States | |
| 650 | 4 | |a Medical care, Cost of |z United States |x Mathematical models | |
| 650 | 4 | |a Outcome Assessment (Health Care) |z United States | |
| 650 | 4 | |a Quality Indicators, Health Care |z United States | |
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Datensatz im Suchindex
| _version_ | 1804135550137925632 |
|---|---|
| adam_text | Contents
; 1 Introduction 13
: 1.1 Research Objective 14
1.2 Organization of the Dissertation 15
j
j 2 The Causality of Volume Outcome in the Context of Health Care
Industries 17
| 2.1 Practice Makes Perfect Effect 17
I 2.1.1 Learning Curves 17
I 2.1.2 Economies of Scale Effects 27
2.2 Selective Referral Effect 32
2.2.1 Characteristics of Health Care Goods 32
2.2.2 Participants in Health Care Markets 34
2.2.3 Hospital Selection 38
2.2.4 Selective Referral and Hospital Volume 42
3 Volume Outcome Research 43
3.1 Background and Overview 43
3.2 Methodology of Volume Outcome Studies 48
3.2.1 Data 49
3.2.2 Outcome Measures 53
3.2.3 Risk Adjustment 56
3.2.4 Cross Sectional Versus Longitudinal Analysis 59
3.2.5 Volume Specification 60
3.2.6 Applicability of Administrative Data for Volume Outcome
Studies 61
3.3 Coronary Artery Bypass Graft Surgeries and Volume Outcome 62
3.3.1 Overview of the Development of CABGs and Its Impor¬
tance 63
3.3.2 General Outline of CABG Volume Outcome Research 64
3.3.3 Review of Recent Volume Outcome Literature With Re¬
gard To CABGs 66
4 Analysis of the Causative Volume Outcome Relationship for
CABGs 81
4.1 Data and Population 81
4.2 Development of the Risk Adjustment Model 85
4.2.1 Risk Factors 85
4.2.2 Complete Risk Adjustment Models and Results 94
4.3 Causality and the Volume Outcome Relationship 102
7
4.3.1 Presence of a Volume Outcome Relationship 102
4.3.2 Causal Volume Outcome Relationship 112
4.3.3 Replication of a Different Approach 118
4.4 Synopsis 123
5 Policy Implications of a Causative Volume Outcome Relationship 127
5.1 Simulation of a Regionalization/Centralization Policy 127
5.1.1 Intentions of Regionalization/Centralization 127
5.1.2 Simulation Methods and Results 129
5.2 Volume Outcome as an Efficiency Defense in US Antitrust 133
5.2.1 Efficiency Defense in US Antitrust 133
5.2.2 Methodical Framework 136
5.2.3 Analytical Approach 142
5.2.4 Standard Merger Simulation 148
5.2.5 Simulation Based on a Real Merger 154
5.2.6 Conclusion 168
5.3 Resume 168
6 Summary and Perspective 171
Appendix 175
A Coronary Artery Bypass Graft (CABG) 177
B Risk Adjustment 179
C Variables Overview 199
D Results 201
Bibliography 215
List of Figures
4.1 Hospitals Volume and Mortality for CABGs in California 1985
1999 105
5.1 Regionalization Policy: Outcome and Costs All Three Ap¬
proaches 132
5.2 Consumers Surplus Effects of a Merger 138
8
5.3 Method of Welfare Calculation 148
5.4 Alta Bates Summit Merger: Area Map 157
5.5 Relevant Market of the Alta Bates Summit Merger 162
B.I Hospitals Volume and Mortality for CABGs in California 1985
1999 Risk adjustment Model 1 and 2 195
B.2 Hospitals Volume and Mortality for CABGs in California 1996
1999 Risk adjustment Model 3 and 4 196
B.3 Hospitals Volume and Mortality for CABGs in California 1996
1999 Comparison of Model 2 and 4 197
List of Tables
3.1 Recent CABG Volume Outcome Studies 79
4.1 Descriptive Statistics of Selected Variables 83
4.2 Potential Risk Factors Demographics and Hospitalization Char¬
acteristics (%) 87
4.3 Potential Risk Factors Frequency of Diagnoses 93
4.4 Mortality in Low and High Volume Hospitals (%) 103
4.5 Pseudo R2 for Different Approaches 125
4.6 First Stage: OLS 125
4.7 Point Estimates of Square Root of Volume 126
4.8 Mortality Elasticities of IV Approaches 126
5.1 Regionalization Policy: Simulation Results Based on Minimum
Volumes 131
5.2 Studies with Price and Income Elasticities for Health Care 139
5.3 Value of Life Studies 141
5.4 Basic Data of the Californian CABG Market 143
5.5 Results of the Standard Merger Case (using the fixed effects
IV probit model) 152
5.6 Results of the Standard Merger Case (using the simple IV probit
model) 153
5.7 Odds Ratio of Other Treatments Compared to CABGs 160
5.8 Hospitals in the Relevant Market 163
5.9 Results of the Alta Bates Summit Merger (using the fixed effects
IV probit model) 167
9
5.10 Results of the Alta Bates Summit Merger (using the simple IV
probit model) 167 :
B.I Potential Risk Factors Annual Frequency of Demographics and
Hospitalization Characteristics (%) 180
B.2 Potential Risk Factors Annual Mortality for Demographics and
Hospitalization Characteristics (%) 181 j
B.3 Coding Source of Admission 182 j
B.4 ICD 9 CM Codes For Medical Risk Factors 183 j
B.5 Risk Adjustment Models 190 j
B.6 A Simple Test for Coding Bias: Influencing Factors of Hyper ]
tension 194
D.I Volume Outcome: Probit Results 201
D.2 Volume Outcome: Fixed Effects Probit Results 203
D.3 Volume Outcome: Random Effects Probit Results 205
D.4 Causative Volume Outcome: Two Stage Probit Results (Cor¬
rected Standard Errors) 207
D.5 Causative Volume Outcome: Two Stage Fixed Effect Probit
Results 210
D.6 Replication: Multinomial Hospital Model Parameters 212
D.7 Replication: First Stage OLS Results 212
D.8 Replication: Two Stage Probit Results 213
10
|
| adam_txt |
Contents
; 1 Introduction 13
: 1.1 Research Objective 14
1.2 Organization of the Dissertation 15
j
j 2 The Causality of Volume Outcome in the Context of Health Care
\ Industries 17
| 2.1 Practice Makes Perfect Effect 17
I 2.1.1 Learning Curves 17
I 2.1.2 Economies of Scale Effects 27
2.2 Selective Referral Effect 32
2.2.1 Characteristics of Health Care Goods 32
2.2.2 Participants in Health Care Markets 34
2.2.3 Hospital Selection 38
2.2.4 Selective Referral and Hospital Volume 42
3 Volume Outcome Research 43
3.1 Background and Overview 43
3.2 Methodology of Volume Outcome Studies 48
3.2.1 Data 49
3.2.2 Outcome Measures 53
3.2.3 Risk Adjustment 56
3.2.4 Cross Sectional Versus Longitudinal Analysis 59
3.2.5 Volume Specification 60
3.2.6 Applicability of Administrative Data for Volume Outcome
Studies 61
3.3 Coronary Artery Bypass Graft Surgeries and Volume Outcome 62
3.3.1 Overview of the Development of CABGs and Its Impor¬
tance 63
3.3.2 General Outline of CABG Volume Outcome Research 64
3.3.3 Review of Recent Volume Outcome Literature With Re¬
gard To CABGs 66
4 Analysis of the Causative Volume Outcome Relationship for
CABGs 81
4.1 Data and Population 81
4.2 Development of the Risk Adjustment Model 85
4.2.1 Risk Factors 85
4.2.2 Complete Risk Adjustment Models and Results 94
4.3 Causality and the Volume Outcome Relationship 102
7
4.3.1 Presence of a Volume Outcome Relationship 102
4.3.2 Causal Volume Outcome Relationship 112
4.3.3 Replication of a Different Approach 118
4.4 Synopsis 123
5 Policy Implications of a Causative Volume Outcome Relationship 127
5.1 Simulation of a Regionalization/Centralization Policy 127
5.1.1 Intentions of Regionalization/Centralization 127
5.1.2 Simulation Methods and Results 129
5.2 Volume Outcome as an Efficiency Defense in US Antitrust 133
5.2.1 Efficiency Defense in US Antitrust 133
5.2.2 Methodical Framework 136
5.2.3 Analytical Approach 142
5.2.4 Standard Merger Simulation 148
5.2.5 Simulation Based on a Real Merger 154
5.2.6 Conclusion 168
5.3 Resume 168
6 Summary and Perspective 171
Appendix 175
A Coronary Artery Bypass Graft (CABG) 177
B Risk Adjustment 179
C Variables Overview 199
D Results 201
Bibliography 215
List of Figures
4.1 Hospitals Volume and Mortality for CABGs in California 1985
1999 105
5.1 Regionalization Policy: Outcome and Costs All Three Ap¬
proaches 132
5.2 Consumers Surplus Effects of a Merger 138
8
5.3 Method of Welfare Calculation 148
5.4 Alta Bates Summit Merger: Area Map 157
5.5 Relevant Market of the Alta Bates Summit Merger 162
B.I Hospitals Volume and Mortality for CABGs in California 1985
1999 Risk adjustment Model 1 and 2 195
B.2 Hospitals Volume and Mortality for CABGs in California 1996
1999 Risk adjustment Model 3 and 4 196
B.3 Hospitals Volume and Mortality for CABGs in California 1996
1999 Comparison of Model 2 and 4 197
List of Tables
3.1 Recent CABG Volume Outcome Studies 79
4.1 Descriptive Statistics of Selected Variables 83
4.2 Potential Risk Factors Demographics and Hospitalization Char¬
acteristics (%) 87
4.3 Potential Risk Factors Frequency of Diagnoses 93
4.4 Mortality in Low and High Volume Hospitals (%) 103
4.5 Pseudo R2 for Different Approaches 125
4.6 First Stage: OLS 125
4.7 Point Estimates of Square Root of Volume 126
4.8 Mortality Elasticities of IV Approaches 126
5.1 Regionalization Policy: Simulation Results Based on Minimum
Volumes 131
5.2 Studies with Price and Income Elasticities for Health Care 139
5.3 Value of Life Studies 141
5.4 Basic Data of the Californian CABG Market 143
5.5 Results of the Standard Merger Case (using the fixed effects
IV probit model) 152
5.6 Results of the Standard Merger Case (using the simple IV probit
model) 153
5.7 Odds Ratio of Other Treatments Compared to CABGs 160
5.8 Hospitals in the Relevant Market 163
5.9 Results of the Alta Bates Summit Merger (using the fixed effects
IV probit model) 167
9
5.10 Results of the Alta Bates Summit Merger (using the simple IV
probit model) 167 :
B.I Potential Risk Factors Annual Frequency of Demographics and
Hospitalization Characteristics (%) 180
B.2 Potential Risk Factors Annual Mortality for Demographics and
Hospitalization Characteristics (%) 181 j
B.3 Coding "Source of Admission" 182 j
B.4 ICD 9 CM Codes For Medical Risk Factors 183 j
B.5 Risk Adjustment Models 190 j
B.6 A Simple Test for Coding Bias: Influencing Factors of Hyper ]
tension 194
D.I Volume Outcome: Probit Results 201
D.2 Volume Outcome: Fixed Effects Probit Results 203
D.3 Volume Outcome: Random Effects Probit Results 205
D.4 Causative Volume Outcome: Two Stage Probit Results (Cor¬
rected Standard Errors) 207
D.5 Causative Volume Outcome: Two Stage Fixed Effect Probit
Results 210
D.6 Replication: Multinomial Hospital Model Parameters 212
D.7 Replication: First Stage OLS Results 212
D.8 Replication: Two Stage Probit Results 213
10 |
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| index_date | 2024-07-02T15:21:01Z |
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| owner | DE-384 DE-12 DE-N2 DE-945 DE-2070s |
| owner_facet | DE-384 DE-12 DE-N2 DE-945 DE-2070s |
| physical | 246 S. Ill., graph. Darst., Kt. |
| publishDate | 2006 |
| publishDateSearch | 2006 |
| publishDateSort | 2006 |
| publisher | Nomos-Verl.-Ges. |
| record_format | marc |
| series | Gesundheitsökonomische Beiträge |
| series2 | Gesundheitsökonomische Beiträge |
| spelling | Seider, Harald Verfasser aut Volume-outcome and its impact on US health care markets by Harald Seider 1. Aufl. Baden-Baden Nomos-Verl.-Ges. 2006 246 S. Ill., graph. Darst., Kt. txt rdacontent n rdamedia nc rdacarrier Gesundheitsökonomische Beiträge 50 Zugl.: Augsburg, Univ., Diss., 2004 Mathematisches Modell Coronary artery bypass Economic aspects United States Economies of scale United States Health Services utilization United States Medical care, Cost of United States Mathematical models Outcome Assessment (Health Care) United States Quality Indicators, Health Care United States Qualität (DE-588)4047966-3 gnd rswk-swf Dienstleistung (DE-588)4012178-1 gnd rswk-swf Krankenhaus (DE-588)4032786-3 gnd rswk-swf Skalenertrag (DE-588)4306169-2 gnd rswk-swf USA USA (DE-588)4078704-7 gnd rswk-swf (DE-588)4113937-9 Hochschulschrift gnd-content USA (DE-588)4078704-7 g Krankenhaus (DE-588)4032786-3 s Dienstleistung (DE-588)4012178-1 s Qualität (DE-588)4047966-3 s Skalenertrag (DE-588)4306169-2 s DE-604 Gesundheitsökonomische Beiträge 50 (DE-604)BV000781138 50 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014926655&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Seider, Harald Volume-outcome and its impact on US health care markets Gesundheitsökonomische Beiträge Mathematisches Modell Coronary artery bypass Economic aspects United States Economies of scale United States Health Services utilization United States Medical care, Cost of United States Mathematical models Outcome Assessment (Health Care) United States Quality Indicators, Health Care United States Qualität (DE-588)4047966-3 gnd Dienstleistung (DE-588)4012178-1 gnd Krankenhaus (DE-588)4032786-3 gnd Skalenertrag (DE-588)4306169-2 gnd |
| subject_GND | (DE-588)4047966-3 (DE-588)4012178-1 (DE-588)4032786-3 (DE-588)4306169-2 (DE-588)4078704-7 (DE-588)4113937-9 |
| title | Volume-outcome and its impact on US health care markets |
| title_auth | Volume-outcome and its impact on US health care markets |
| title_exact_search | Volume-outcome and its impact on US health care markets |
| title_exact_search_txtP | Volume-outcome and its impact on US health care markets |
| title_full | Volume-outcome and its impact on US health care markets by Harald Seider |
| title_fullStr | Volume-outcome and its impact on US health care markets by Harald Seider |
| title_full_unstemmed | Volume-outcome and its impact on US health care markets by Harald Seider |
| title_short | Volume-outcome and its impact on US health care markets |
| title_sort | volume outcome and its impact on us health care markets |
| topic | Mathematisches Modell Coronary artery bypass Economic aspects United States Economies of scale United States Health Services utilization United States Medical care, Cost of United States Mathematical models Outcome Assessment (Health Care) United States Quality Indicators, Health Care United States Qualität (DE-588)4047966-3 gnd Dienstleistung (DE-588)4012178-1 gnd Krankenhaus (DE-588)4032786-3 gnd Skalenertrag (DE-588)4306169-2 gnd |
| topic_facet | Mathematisches Modell Coronary artery bypass Economic aspects United States Economies of scale United States Health Services utilization United States Medical care, Cost of United States Mathematical models Outcome Assessment (Health Care) United States Quality Indicators, Health Care United States Qualität Dienstleistung Krankenhaus Skalenertrag USA Hochschulschrift |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014926655&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| volume_link | (DE-604)BV000781138 |
| work_keys_str_mv | AT seiderharald volumeoutcomeanditsimpactonushealthcaremarkets |