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The influence of social deprivation on length of hospitalisation

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  • Engin Yilmaz
  • Denis Raynaud

Abstract

The implementation of activity-based payment system named T2A—tarification à l’activité—in 2004 profoundly modified the financing of French hospitals. Presently applied to activities concerning medicine, surgery and obstetrics, the pricing for these activities was developed using the National Costs Study. The considerable differences observed between costs in the private sector and those in the public sector are in part justified, by the latter, by caring for patients with social deprivation. The goal of this study is to measure the influence of social deprivation on the length of hospitalisation. A survey on inpatient social deprivation was carried out from November to December 2008 by the French Ministry of Health (Department of Research, Study, Evaluation and Statistics—DREES, and technical agency of Hospital information—ATIH). Four dimensions of social deprivation were taken into consideration after a previous qualitative study: social isolation, quality of housing, level of income and access to rights. The sample is based on 27 hospitals, including public and private (for-profit and not-for-profit), representing 57,175 stays, 6,800 of which were patients with social deprivation. After multivariate analyses adjusted for age, severity of illness and DRG, we found that there was a longer length of stay for inpatients with social deprivation (+16%), and in particular for patients living in social isolation (+17%) and for patients with inadequate housing (+17%). The impact of low income on the length of stay is less important. However, low income associated with inadequate housing significantly increases lengths of stay (+24%). Copyright Springer-Verlag 2013

Suggested Citation

  • Engin Yilmaz & Denis Raynaud, 2013. "The influence of social deprivation on length of hospitalisation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 243-252, April.
    • Handle: RePEc:spr:eujhec:v:14:y:2013:i:2:p:243-252
    DOI: 10.1007/s10198-011-0365-4
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    References listed on IDEAS

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    1. Chungkham Singh & Laishram Ladusingh, 2010. "Inpatient length of stay: a finite mixture modeling analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(2), pages 119-126, April.
    2. Nigel Rice & Andrew Jones, 1997. "Multilevel models and health economics," Health Economics, John Wiley & Sons, Ltd., vol. 6(6), pages 561-575, November.
    3. Julia Bonastre & Marc le Vaillant & Gerard de Pouvourville, 2011. "The impact of research on hospital costs of care: an empirical study," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 73-84, January.
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    More about this item

    Keywords

    Social deprivation; Length of stay; Case mix; DRG; I18; I32; C35;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty
    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions

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