Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/312849 
Year of Publication: 
2022
Citation: 
[Journal:] The European Journal of Health Economics [ISSN:] 1618-7601 [Volume:] 24 [Issue:] 5 [Publisher:] Springer [Place:] Berlin, Heidelberg [Year:] 2022 [Pages:] 785-802
Publisher: 
Springer, Berlin, Heidelberg
Abstract: 
Objective: Development of an aggregate quality index to evaluate hospital performance in cardiovascular events treatment. Methods: We applied a two-stage regression approach using an accelerated failure time model based on variance weights to estimate hospital quality over four cardiovascular interventions: elective coronary bypass graft, elective cardiac resynchronization therapy, and emergency treatment for acute myocardial infarction. Mortality and readmissions were used as outcomes. For the estimation we used data from a statutory health insurer in Germany from 2005 to 2016. Results: The precision-based weights calculated in the first stage were higher for mortality than for readmissions. In general, teaching hospitals performed better in our ranking of hospital quality compared to non-teaching hospitals, as did private not-for-profit hospitals compared to hospitals with public or private for-profit ownership. Discussion: The proposed approach is a new method to aggregate single hospital quality outcomes using objective, precision-based weights. Likelihood-based accelerated failure time models make use of existing data more efficiently compared to widely used models relying on dichotomized data. The main advantage of the variance-based weights approach is that the extent to which an indicator contributes to the aggregate index depends on the amount of its variance.
Subjects: 
Quality of care
Hospital
Accelerated failure time model
Cardiovascular diseases
JEL: 
I11
Persistent Identifier of the first edition: 
Creative Commons License: 
cc-by Logo
Document Type: 
Article
Document Version: 
Published Version

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