Medical Management Centre, Karolinska Institutet, 171 77 Stockholm, Sweden.
Eur J Health Econ. 2011 Dec;12(6):509-19. doi: 10.1007/s10198-010-0263-1. Epub 2010 Jul 29.
This paper estimates cost efficiency scores using the bootstrap bias-corrected procedure, including variables for teaching and research, for the performance of university hospitals in the Nordic countries. Previous research has shown that hospital provision of research and education interferes with patient care routines and inflates the costs of health care services, turning university hospitals into outliers in comparative productivity and efficiency analyses. The organisation of patient care, medical education and clinical research as well as available data at the university hospital level are highly similar in the Nordic countries, creating a data set of comparable decision-making units suitable for a cross-country cost efficiency analysis. The results demonstrate significant differences in university hospital cost efficiency when variables for teaching and research are entered into the analysis, both between and within the Nordic countries. The results of a second-stage analysis show that the most important explanatory variables are geographical location of the hospital and the share of discharges with a high case weight. However, a substantial amount of the variation in cost efficiency at the university hospital level remains unexplained.
本文使用自举偏差校正程序估算了成本效率得分，其中包括教学和研究变量，用于评估北欧国家大学医院的绩效。先前的研究表明，医院提供的研究和教育会干扰患者护理常规，并增加医疗服务的成本，使大学医院成为比较生产力和效率分析中的异常值。北欧国家的患者护理、医学教育和临床研究的组织以及大学医院层面的可用数据高度相似，为适合跨国成本效率分析的可比决策单位数据集创造了条件。研究结果表明，当分析中包含教学和研究变量时，北欧国家内部和之间的大学医院成本效率存在显著差异。第二阶段分析的结果表明，最重要的解释变量是医院的地理位置和高病例权重出院人数的比例。然而，大学医院层面成本效率的很大一部分差异仍然无法解释。
