Department of Economics and Related Studies, University of York, York, UK.
Centre for Health Economics, University of York, York, YO10 5DD, UK.
Eur J Health Econ. 2019 Feb;20(1):7-26. doi: 10.1007/s10198-017-0935-1. Epub 2017 Oct 23.
Prospective payment systems fund hospitals based on a fixed-price regime that does not directly distinguish between specialist and general hospitals. We investigate whether current prospective payments in England compensate for differences in costs between specialist orthopaedic hospitals and trauma and orthopaedics departments in general hospitals. We employ reference cost data for a sample of hospitals providing services in the trauma and orthopaedics specialty. Our regression results suggest that specialist orthopaedic hospitals have on average 13% lower profit margins. Under the assumption of break-even for the average trauma and orthopaedics department, two of the three specialist orthopaedic hospitals appear to make a loss on their activity. The same holds true for 33% of departments in our sample. Patient age and severity are the main drivers of such differences.
按预定支付制度，医院的资金是根据固定价格机制提供的，这种机制并不能直接区分专科医院和综合医院。我们调查了目前在英国的预定支付制度是否补偿了专科医院和综合医院创伤和骨科部门之间的成本差异。我们使用了为提供创伤和骨科专业服务的医院样本的参考成本数据。我们的回归结果表明，骨科专科医院的平均利润率低 13%。在平均创伤和骨科部门收支平衡的假设下，三家骨科专科医院中有两家似乎在其业务活动中出现亏损。我们样本中的 33%的部门也是如此。患者年龄和严重程度是造成这种差异的主要因素。
