IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v230y2019icp309-317.html
   My bibliography  Save this article

Effects of introducing a fee for inpatient overstays on the rate of death and readmissions across municipalities in Norway

Author

Listed:
  • Ambugo, Eliva Atieno
  • Hagen, Terje P.

Abstract

The Norwegian healthcare coordination reform (Samhandlingsreformen) was implemented from January 1, 2012. In addition to providing municipalities with funding to strengthen their health infrastructure, it required municipalities to pay hospitals a daily fee for patients who, having been declared ready for discharge and in need of municipal health services, were not received by the municipalities on time. This study examines the effects of the reform on the rate of death and readmissions occurring within 60 days of hospitalization. We use aggregated municipal data for years 2009, 2010, 2012–2014 (N = 1646) for Norwegian patients (age 18+) hospitalized in the same years for COPD/asthma, heart failure, hip fracture, and stroke. We stratify our analyses of the municipal data by these patient groups. Our linear regression models test for moderated (interaction) effects whereby associations between the reform and the rate of death and readmissions vary by whether or not patients were classified as ready for discharge and in need of follow-up care in the municipality. The models adjust for municipal sociodemographic and health characteristics. We found no statistically significant moderated effects of the reform across the patient groups, except for patients with stroke (b = .027, SE = 0.109, p < .05). Specifically, compared to the pre-reform period (2009–2010), the post-reform period (2012–2014) was associated with a higher rate of readmissions at high predicted values of needing follow-up care. Even though our analyses of municipal data suggest that patients with stroke are vulnerable to the reform and its incentive scheme, there is no strong evidence overall to suggest that the Norwegian healthcare coordination reform is functioning in a manner that exacerbates the risk of death and readmissions.

Suggested Citation

  • Ambugo, Eliva Atieno & Hagen, Terje P., 2019. "Effects of introducing a fee for inpatient overstays on the rate of death and readmissions across municipalities in Norway," Social Science & Medicine, Elsevier, vol. 230(C), pages 309-317.
    • Handle: RePEc:eee:socmed:v:230:y:2019:i:c:p:309-317
    DOI: 10.1016/j.socscimed.2019.04.006
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953619302060
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2019.04.006?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Kathleen Carey, 2015. "Measuring the Hospital Length of Stay/Readmission Cost Trade‐Off Under a Bundled Payment Mechanism," Health Economics, John Wiley & Sons, Ltd., vol. 24(7), pages 790-802, July.
    2. Hagen, Terje P. & Ambugo, Eliva Atieno & Melberg, Hans Olav, 2016. "Liggetider og reinnleggelser i somatiske sykehus før og etter Samhandlingsreformen," HERO Online Working Paper Series 2016:5, University of Oslo, Health Economics Research Programme.
    3. Johansson, Lennarth, 1997. "Decentralisation from acute to home care settings in Sweden," Health Policy, Elsevier, vol. 41(Supplemen), pages 131-143, September.
    4. Afsaneh Bjorvatn, 2013. "Hospital readmission among elderly patients," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(5), pages 809-820, October.
    5. Burgess, James F. & Hockenberry, Jason M., 2014. "Can all cause readmission policy improve quality or lower expenditures? A historical perspective on current initiatives," Health Economics, Policy and Law, Cambridge University Press, vol. 9(2), pages 193-213, April.
    6. Kristensen, Søren Rud & Bech, Mickael & Quentin, Wilm, 2015. "A roadmap for comparing readmission policies with application to Denmark, England, Germany and the United States," Health Policy, Elsevier, vol. 119(3), pages 264-273.
    7. Martin, Stephen & Street, Andrew & Han, Lu & Hutton, John, 2016. "Have hospital readmissions increased in the face of reductions in length of stay? Evidence from England," Health Policy, Elsevier, vol. 120(1), pages 89-99.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Nilsen, Sara Marie & Asheim, Andreas & Carlsen, Fredrik & Anthun, Kjartan Sarheim & Vatten, Lars Johan & Aam, Stina & Davies, Neil M & Bjørngaard, Johan Håkon, 2022. "How do busy hospital circumstances affect mortality and readmission within 60 days: A cohort study of 680 000 acute admissions in Norway," Health Policy, Elsevier, vol. 126(8), pages 808-815.
    2. Walsh, Brendan & Wren, Maev-Ann & Smith, Samantha & Lyons, Seán & Eighan, James & Morgenroth, Edgar, 2019. "An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital," Research Series, Economic and Social Research Institute (ESRI), number RS91.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Brendan Walsh & Samantha Smith & Maev-Ann Wren & James Eighan & Seán Lyons, 2022. "The impact of inpatient bed capacity on length of stay," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(3), pages 499-510, April.
    2. Walsh, Brendan & Wren, Maev-Ann & Smith, Samantha & Lyons, Seán & Eighan, James & Morgenroth, Edgar, 2019. "An analysis of the effects on Irish hospital care of the supply of care inside and outside the hospital," Research Series, Economic and Social Research Institute (ESRI), number RS91.
    3. 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.
    4. Snorre Kverndokk & Hans Olav Melberg, 2016. "Using Fees to Reduce Bed-Blocking: A Game between Hospitals and Care Providers," CESifo Working Paper Series 6146, CESifo.
    5. Di Matteo, Livio, 2000. "The determinants of the public-private mix in Canadian health care expenditures: 1975-1996," Health Policy, Elsevier, vol. 52(2), pages 87-112, June.
    6. Jeanette W Kirk & Ditte M Sivertsen & Janne Petersen & Per Nilsen & Helle V Petersen, 2016. "Barriers and facilitators for implementing a new screening tool in an emergency department: A qualitative study applying the Theoretical Domains Framework," Journal of Clinical Nursing, John Wiley & Sons, vol. 25(19-20), pages 2786-2797, October.
    7. Martin, Stephen & Street, Andrew & Han, Lu & Hutton, John, 2016. "Have hospital readmissions increased in the face of reductions in length of stay? Evidence from England," Health Policy, Elsevier, vol. 120(1), pages 89-99.
    8. Ann P. Bartel & Carri W. Chan & Song-Hee Kim, 2020. "Should Hospitals Keep Their Patients Longer? The Role of Inpatient Care in Reducing Postdischarge Mortality," Management Science, INFORMS, vol. 66(6), pages 2326-2346, June.
    9. Møller Dahl, Christian & Planck Kongstad, Line, 2017. "The costs of acute readmissions to a different hospital – Does the effect vary across provider types?," Social Science & Medicine, Elsevier, vol. 183(C), pages 116-125.
    10. Andrea S Gershon & Deva Thiruchelvam & Shawn Aaron & Matthew Stanbrook & Nicholas Vozoris & Wan C Tan & Eunice Cho & Teresa To, 2019. "Socioeconomic status (SES) and 30-day hospital readmissions for chronic obstructive pulmonary (COPD) disease: A population-based cohort study," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-16, May.
    11. Damien Échevin & Bernard Fortin & Aristide Houndetoungan, 2023. "Healthcare Quality by Specialists under a Mixed Compensation System: an Empirical Analysis," CIRANO Working Papers 2023s-19, CIRANO.
    12. Lobo, Mariana F & Azzone, Vanessa & Lopes, Fernando & Freitas, Alberto & Costa-Pereira, Altamiro & Normand, Sharon-Lise & Teixeira-Pinto, Armando, 2020. "Understanding the large heterogeneity in hospital readmissions and mortality for acute myocardial infarction," Health Policy, Elsevier, vol. 124(7), pages 684-694.
    13. 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.
    14. Caruso, Enza & Rossi Zadra, Andrea, 2020. "The trade-off between costs and outcome after cardiac surgery. Evidence from an Italian administrative registry," Health Policy, Elsevier, vol. 124(12), pages 1345-1353.
    15. Kristensen, Søren Rud & Bech, Mickael & Quentin, Wilm, 2015. "A roadmap for comparing readmission policies with application to Denmark, England, Germany and the United States," Health Policy, Elsevier, vol. 119(3), pages 264-273.
    16. Damien Bricard & Zeynep Or, 2019. "Impact of early primary care follow-up after discharge on hospital readmissions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(4), pages 611-623, June.
    17. Damien Bricard & Zeynep Or, 2018. "Does an Early Primary Care Follow-up after Discharge Reduce Readmissions for Heart Failure Patients?," Working Papers DT73, IRDES institut for research and information in health economics, revised Mar 2018.
    18. Yan Meng & Xueyan Zhao & Xibin Zhang & Jiti Gao, 2017. "A panel data analysis of hospital variations in length of stay for hip replacements: Private versus public," Monash Econometrics and Business Statistics Working Papers 20/17, Monash University, Department of Econometrics and Business Statistics.
    19. Fournaise, Anders & Andersen-Ranberg, Karen & Lauridsen, Jørgen T. & Espersen, Kurt & Gudex, Claire & Bech, Mickael, 2023. "Conceptual framework for acute community health care services – Illustrated by assessing the development of services in Denmark," Social Science & Medicine, Elsevier, vol. 324(C).
    20. Germán M. Izón & Chelsea A. Pardini, 2018. "Association Between Medicare’s Mandatory Hospital Value-Based Purchasing Program and Cost Inefficiency," Applied Health Economics and Health Policy, Springer, vol. 16(1), pages 79-90, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:230:y:2019:i:c:p:309-317. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.