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Reimbursement systems and quality of hospital care: An empirical analysis for Italy

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  • Cavalieri, Marina
  • Gitto, Lara
  • Guccio, Calogero

Abstract

There is an ongoing debate about the effect of different reimbursement systems on hospital performance and quality of care. The present paper aims at contributing to this literature by analysing the impact of different hospital payment schemes on patients’ outcomes in Italy. The Italian National Health Service is, indeed, a particularly interesting case since it has been subject to a considerable decentralization process with wider responsibilities devolved to regional governments. Therefore, great variability exists in the way tariffs are used, as Regions have settled them in accordance with the characteristics of health care providers. An empirical analysis of the Italian hospital system is carried out using data from the National Program for Outcome Assessment on mortality and readmissions for Acute Myocardial Infarction (AMI), Congestive Heart Failure (CHF), stroke and Chronic Obstructive Pulmonary Diseases (COPD) in the years 2009–2010. The results show that hospitals operating in Regions where prospective payments are used more extensively are generally associated with better quality of care.

Suggested Citation

  • Cavalieri, Marina & Gitto, Lara & Guccio, Calogero, 2013. "Reimbursement systems and quality of hospital care: An empirical analysis for Italy," Health Policy, Elsevier, vol. 111(3), pages 273-289.
    • Handle: RePEc:eee:hepoli:v:111:y:2013:i:3:p:273-289
    DOI: 10.1016/j.healthpol.2013.05.014
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    1. Torsten Oliver Salge & David Antons & Michael Barrett & Rajiv Kohli & Eivor Oborn & Stavros Polykarpou, 2022. "How IT Investments Help Hospitals Gain and Sustain Reputation in the Media: The Role of Signaling and Framing," Information Systems Research, INFORMS, vol. 33(1), pages 110-130, March.
    2. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    3. Guccio, Calogero & Lisi, Domenico & Pignataro, Giacomo, 2014. "Readmission and Hospital Quality under Prospective Payment System," MPRA Paper 56490, University Library of Munich, Germany.
    4. Meilin Möllenkamp & Benedetta Pongiglione & Stefan Rabbe & Aleksandra Torbica & Jonas Schreyögg, 2022. "Spillover effects and other determinants of medical device uptake in the presence of a medical guideline: An analysis of drug‐eluting stents in Germany and Italy," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 157-178, September.
    5. Domenico Lisi & Luigi Siciliani & Odd Rune Straume, 2020. "Hospital competition under pay‐for‐performance: Quality, mortality, and readmissions," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 29(2), pages 289-314, April.
    6. Finocchiaro Castro, Massimo & Guccio, Calogero & Pignataro, Giacomo & Rizzo, Ilde, 2014. "The effects of reimbursement mechanisms on medical technology diffusion in the hospital sector in the Italian NHS," Health Policy, Elsevier, vol. 115(2), pages 215-229.
    7. Cavalieri, M. & Guccio, C. & Lisi, D. & Pignataro, G., 2015. "Does the Extent of Per-Case Payment System Affect Hospital Efficiency? Evidence from the Italian NHS," Health, Econometrics and Data Group (HEDG) Working Papers 15/29, HEDG, c/o Department of Economics, University of York.
    8. Bertoli, Paola & Grembi, Veronica, 2017. "The political economy of diagnosis-related groups," Social Science & Medicine, Elsevier, vol. 190(C), pages 38-47.
    9. Yuxi Wang & Simone Ghislandi & Aleksandra Torbica, 2020. "Investigating the geographic disparity in quality of care: the case of hospital readmission after acute myocardial infarction in Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1149-1168, November.
    10. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    11. Panagiotis Mitropoulos & Panagiotis D. Zervopoulos & Ioannis Mitropoulos, 2020. "Measuring performance in the presence of noisy data with targeted desirable levels: evidence from healthcare units," Annals of Operations Research, Springer, vol. 294(1), pages 537-566, November.
    12. Michele Bisceglia & Roberto Cellini & Luca Grilli, 2018. "Regional regulators in health care service under quality competition: A game theoretical model," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1821-1842, November.
    13. Calogero Guccio & Domenico Lisi & Giacomo Pignataro, 2016. "Readmission and Hospital Quality under Different Payment Regimes," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 72(4), pages 453-474, December.
    14. Alper Aslan & Angeliki Menegaki & Can Tugcu, 2016. "Health and economic growth in high-income countries revisited: evidence from an augmented production function for the period 1980–2009," Quality & Quantity: International Journal of Methodology, Springer, vol. 50(2), pages 937-953, March.

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