Scandinavian Working Papers in Economics

DaCHE discussion papers,
University of Southern Denmark, Dache - Danish Centre for Health Economics

No 2010:3: Does better structure and process management provide higher outcome quality for the individual patient and among Danish hospital departments?

Anne Hvenegaard (), Dorte Gyrd-Hansen (), Jacob Arendt (), Torben Højmark Sørensen, Jesper Laustsen and Leif Panduro Jensen
Additional contact information
Anne Hvenegaard: Danish Institute for Health Services Research
Dorte Gyrd-Hansen: Danish Institute for Health Services Research
Jacob Arendt: University of Southern Denmark - Research Unit for Health Economics
Torben Højmark Sørensen: Danish Institute for Health Services Research
Jesper Laustsen: University Hospital of Aarhus
Leif Panduro Jensen: Gentofte Hospital and Rigshospitalet

Abstract: Objective: The purpose is to explore whether better structure and process management provide better outcome quality for the individual patient and among hospital departments. Methods: Using patient level data in which 4,202 patients across seven vascular departments are pooled we estimate fixed effect logit models for three outcome quality measures; 30 day mortality, death after discharge and wound complications. First, we estimate the association between three process quality measures and the outcome quality for the individual patient. We then profile high- and lowperforming departments with respect to structural and process quality measures to explore whether more or less successful departments are characterised by specific features. Results: For the individual patient our results show that for death after discharge a higher length of stay reduces the risk of dying. At departmental level, our results suggest that staffing decisions may also be an important factor. However, additional research is needed in order to learn more about how structure and process indicators are associated with high-performance. Conclusions: Differences in outcome quality occur due to differences in the needs of patients treated, but also due to differences in how hospital departments organise care.

Keywords: Hospital perfomance; Quality; Costs

JEL-codes: I11

22 pages, June 25, 2010

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