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Comparisons of hospital output in Canada: national and international perspectives

Author

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  • Ruolz Ariste

    (Canadian Institute for Health Information)

  • Kam Yu

    (Lakehead University)

Abstract

Current cost-based approach in measuring health care output does not allow decomposition of health care expenditure into price and output components. In this paper we propose an episode-based direction measurement method which closely resembles the concept of output in the system of national accounts. Using data from the Canadian Institute for Health Information, we calculate a quality unadjusted output index of the Canadian hospital sector for the periods 1996–2005. The result shows that total output increases at an average annual growth rate of 1.49%. We expect that with the quality adjustment the actual rate is higher. This is in contrast with the long-held assumption that health care productivity growth is zero. Our results provide key information on the ongoing health care policy debate.

Suggested Citation

  • Ruolz Ariste & Kam Yu, 2017. "Comparisons of hospital output in Canada: national and international perspectives," International Journal of Health Economics and Management, Springer, vol. 17(4), pages 433-451, December.
    • Handle: RePEc:kap:ijhcfe:v:17:y:2017:i:4:d:10.1007_s10754-017-9217-9
    DOI: 10.1007/s10754-017-9217-9
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    References listed on IDEAS

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    1. Gerdtham, Ulf-G. & Jonsson, Bengt, 2000. "International comparisons of health expenditure: Theory, data and econometric analysis," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 1, pages 11-53, Elsevier.
    2. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1.
    3. Matthew D. Shapiro & David W. Wilcox, 1996. "Mismeasurement in the Consumer Price Index: An Evaluation," NBER Chapters, in: NBER Macroeconomics Annual 1996, Volume 11, pages 93-154, National Bureau of Economic Research, Inc.
    4. Ernst R. Berndt & Alisa B. Busch & Richard G. Frank & Sharon-Lise Normand, 2006. "Real Output in Mental Health Care during the 1990s," NBER Chapters, in: Frontiers in Health Policy Research, Volume 9, National Bureau of Economic Research, Inc.
    5. Diewert, Erwin, 2008. "The Measurement of Nonmarket Sector Outputs and Inputs Using Cost Weights," Economics working papers diewert-08-01-18-09-21-07, Vancouver School of Economics, revised 13 Nov 2008.
    6. Andrew Sharpe & Celeste Bradley & Hans Messinger, 2007. "The Measurement of Output and Productivity in the Health Care Sector in Canada: An Overview," CSLS Research Reports 2007-06, Centre for the Study of Living Standards.
    7. David M. Cutler & Mark McClellan & Joseph P. Newhouse & Dahlia Remler, 1998. "Are Medical Prices Declining? Evidence from Heart Attack Treatments," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 113(4), pages 991-1024.
    8. Adriana Lleras-Muney, 2005. "The Relationship Between Education and Adult Mortality in the United States," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 189-221.
    9. Berndt, Ernst R. & Cutler, David M. & Frank, Richard G. & Griliches, Zvi & Newhouse, Joseph P. & Triplett, Jack E., 2000. "Medical care prices and output," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 3, pages 119-180, Elsevier.
    10. Di Matteo, Livio & Di Matteo, Rosanna, 1998. "Evidence on the determinants of Canadian provincial government health expenditures: 1965-1991," Journal of Health Economics, Elsevier, vol. 17(2), pages 211-228, April.
    11. Berndt Ernst R. & Busch Alisa B. & Frank Richard G. & Normand Sharon-Lise, 2006. "Real Output in Mental Health Care during the 1990s," Forum for Health Economics & Policy, De Gruyter, vol. 9(1), pages 1-19, December.
    12. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
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    Cited by:

    1. Andrew Sharpe & Celeste Bradley & Hans Messinger, 2007. "The Measurement of Output and Productivity in the Health Care Sector in Canada: An Overview," CSLS Research Reports 2007-06, Centre for the Study of Living Standards.
    2. Wulong Gu & Stéphane Morin, 2014. "Experimental Measures of Output and Productivity in the Canadian Hospital Sector, 2002 to 2010," NBER Chapters, in: Measuring Economic Sustainability and Progress, pages 575-594, National Bureau of Economic Research, Inc.
    3. W. Diewert, 2012. "The measurement of productivity in the nonmarket sector," Journal of Productivity Analysis, Springer, vol. 37(3), pages 217-229, June.

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    More about this item

    Keywords

    Health care output; System of national accounts; Price index; Quantity index;
    All these keywords.

    JEL classification:

    • C43 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Index Numbers and Aggregation
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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