Unexpected Demand and its Impact on Hospital Cost: The Case of Greece

Edited by Zoe Boutsioli

ISBN: 978-960-6672-59-0, 180 pages

First published in 2010 by ATINER

Price: Paperback: 50 (It includes Shipping and Handling)

Electronic copy: 30

 

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Table of Contents

 

Abstract v

 

Acknowledgments vii

 

Table of Contents ix

 

Chapter 1: Hospital cost and unexpected demand: an introduction

1.1. Introduction 1

1.2. Health care costs: a growing policy concern 2

1.3. The basic hypothesis, research questions and methods 6

1.4. Conclusions 11

 

Chapter 2: The Greek NHS and its cost efficiency problems

2.1. Introduction 13

2.2. The pre-NHS era 15

2.3. The establishment of the Greek NHS and its organization 17

2.4. An evaluation of the Greek NHS 24

2.5. The cost efficiency problems of the Greek NHS 38

2.6. Conclusions 40

 

Chapter 3: Hospital costs: a review of the literature

3.1. Introduction 41

3.3. The standard theory of hospital cost 42

3.3. Demand variability, unexpected demand and hospital cost 51

3.4. Empirical hospital cost studies with demand variability and unexpected demand 55

3.5. Efficiency concepts 64

3.6. Conclusions 67

 

Chapter 4: Data, estimation and model specifications

4.1. Introduction 69

4.2. Models and variables 70

4.3. Sample and data 80

4.4. Sampled and population characteristics of the Greek hospital sector 85

4.5. Estimation of hospital cost functions and hospital efficiency 87

4.6. Data deficiencies 89

4.7. Validity and comparability issues 91

4.8. Conclusions 92

 

Chapter 5: Measuring unexpected demand

5.1. Introduction 93

5.2. Forecasting emergency admissions 94

5.3. Emergency admissions: descriptive statistics 97

5.4. Univariate measurement of unexpected emergency demand 102

5.5. Multivariate measurement of unexpected emergency demand 107

5.6. Comparing the univariate and multivariate measures 110

5.7. Conclusions 112

 

Chapter 6: Hospital costs and unexpected demand: the empirical evidence

6.1. Introduction 113

6.2. Data summary 114

6.3. Model specification 116

6.4. Empirical results 119

6.5. Economies of scale and economies of scope 127

6.6. Conclusions 131

 

Chapter 7: Policy implications

7.1. Introduction 133

7.2. Data, information and policy 134

7.3. Improving hospital cost efficiency 137

7.4. Restructuring the Greek public hospital sector 140

7.5. Policy implementation issues and policy limitations 145

7.6. Conclusions 148

 

Chapter 8: Conclusions and further research

8.1. Introduction 149

8.2. The cost efficiency issues and public hospitals in Greece 150

8.3. Measurement of unexpected demand for hospital admissions in Greece 151

8.4. Hospital cost determination and policies of cost containment 152

8.5. Further research and limitations 154

8.6. Conclusions 156

 

Annexes

Annex I: The questionnaire 157

Annex II: Stationarity of emergency admissions series for the ten hospitals 163

Annex III: Descriptive statistics of hospital cost and explanatory variables (2001-2005) 165

 

Bibliography 167