Abstract
Unwarranted institutional variations in healthcare spending and quality may indicate discrepancies in the quantity of services provided, management efficiency, and staff capability at the hospital level. Because not all variations are unwarranted, analyses must take into account differences in the needs and preferences of the patient groups served. Variations can be influenced by factors such as payment systems, hospital ownership, management methods, resource availability, teaching status, and practice patterns. Although institutional variations may be intertwined with variations at the regional level, some measures of care, such as nosocomial infection rates or indicators of hospital management efficiency, are more meaningful when quantified at the hospital level. The accurate identification of unwarranted variations that stem from causes at the institutional level would also help to identify the stakeholders and decision makers who have the relevant authority and jurisdiction to address the problems. In this chapter, the empirical evidence of institutional variations in healthcare spending, medical practice patterns, and outcomes are introduced. Common methodologies used for measuring variations and the possible determinants of these variations are addressed, and the methods to reduce unwarranted variations are examined.
Keywords
- Payment System
- Breast Conserve Surgery
- Acute Myocardial Infarction Patient
- Institutional Variation
- Healthcare Spending
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Otsubo, T., Imanaka, Y., Morishima, T., Sasaki, N., Park, S., Lee, J. (2015). Variations in Healthcare Spending and Quality Among Institutions. In: Johnson, A., Stukel, T. (eds) Medical Practice Variations. Health Services Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7573-7_89-3
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