Medical Management Centre, Karolinska Institutet, Berzelius väg 3, 171 77 Stockholm, Sweden.
Health Policy. 2013 Sep;112(1-2):80-7. doi: 10.1016/j.healthpol.2013.02.004. Epub 2013 Apr 11.
This article focuses on describing the methodological challenges intrinsic in international comparative studies of hospital productivity and how these challenges have been addressed within the context of hospital comparisons in the Nordic countries. The hospital sectors in the Nordic countries are suitable for international comparison as they exhibit similar structures in the organisation for hospital care, hold administrative data of good quality at the hospital level, apply a similar secondary patient classification system, and use similar definitions of operating costs. The results of a number of studies have suggested marked differences in hospital cost efficiency and hospital productivity across the Nordic countries and the Finnish hospitals have the highest estimates in all the analyses. Explanatory factors that were tested and seemed to be of limited importance included institutional, structural and technical. A factor that is yet to be included in the Nordic hospital productivity comparison is the quality of care. Patient-level data available from linkable national registers in each country enable the development of quality indicators and will be included in the forthcoming hospital productivity studies within the context of the EuroHOPE (European health care outcomes, performance and efficiency) project.
本文重点描述了国际医院生产力比较研究中固有的方法学挑战，以及在北欧国家医院比较的背景下，这些挑战是如何得到解决的。北欧国家的医院部门适合进行国际比较，因为它们在医院护理组织方面具有相似的结构，在医院层面上拥有高质量的管理数据，采用类似的二次患者分类系统，并且使用类似的运营成本定义。多项研究的结果表明，北欧国家之间的医院成本效率和生产力存在显著差异，芬兰的医院在所有分析中都有最高的估计值。经过测试并似乎不重要的解释因素包括制度、结构和技术。一个尚未纳入北欧医院生产力比较的因素是医疗质量。每个国家可从可链接的国家登记处获得患者层面的数据，这使开发质量指标成为可能，并将在即将开展的 EuroHOPE（欧洲医疗保健结果、绩效和效率）项目的医院生产力研究中纳入这些指标。
