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€
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