Centre for Health Economics, University of York, York YO10 5DD, United Kingdom.
Soc Sci Med. 2010 Nov;71(10):1872-81. doi: 10.1016/j.socscimed.2010.06.049. Epub 2010 Sep 15.
Studies of hospital efficiency seldom lead to changes in practice, partly because recommendations are unspecific or results are not seen as robust. We describe a method to compare hospital costs that utilises patient-level data. We perform a two-stage analysis in which we first consider factors that explain costs among patients and then across hospital departments. We illustrate our approach by examining the costs and characteristics of almost one million patients admitted to 136 English NHS hospital obstetrics departments in 2005/2006. We identify those departments with significantly higher costs that need to take action.
医院效率研究很少能导致实践的改变，部分原因是建议不够具体，或者结果不够稳健。我们描述了一种利用患者水平数据来比较医院成本的方法。我们进行了两阶段分析，首先考虑解释患者之间成本的因素，然后考虑跨医院科室的因素。我们通过检查 2005/2006 年近 100 万在英国国民保健署产科病房住院的患者的成本和特征来说明我们的方法。我们确定了那些需要采取行动的成本显著较高的科室。
