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Sex differences in care complexity and cost of cardiac-related procedures as a basis for improving hospital payments systems

Author

Listed:
  • Shuli Brammli-Greenberg

    (The Hebrew University of Jerusalem
    Myers-JDC-Brookdale Institute)

  • Sharvit Fialco

    (Myers-JDC-Brookdale Institute)

  • Neria Shtauber

    (Ministry of Health)

  • Yoram Weiss

    (Hadassah Medical Organization)

Abstract

In this study, we estimate sex differences in care complexity and cost of cardiac-related procedures in order to demonstrate the importance of sex as a risk adjuster in a hospital payment system. We use individual visit-level data for all adult Israelis who underwent either heart valve surgery (HVS) or coronary artery bypass graft surgery (CABG) during the period 2014–2018 in publicly funded hospitals. We find that women undergoing a cardiac-related procedure are more likely to die during hospitalization, they have longer hospital stays, and overall, they are more likely to be care-complex than men. Furthermore, the cost of the surgery itself is higher for women than for men in the case of HVS (though not CABG), and the cost of the post-operative hospital stay is higher in the case of CABG (though not HVS). It is concluded that sex differences should be considered in the calculation of payment for cardiac-related procedures in order to reduce incentives for selection and reduce unwarranted variation in cardiac-care utilization and medical practice.

Suggested Citation

  • Shuli Brammli-Greenberg & Sharvit Fialco & Neria Shtauber & Yoram Weiss, 2023. "Sex differences in care complexity and cost of cardiac-related procedures as a basis for improving hospital payments systems," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(4), pages 539-556, June.
    • Handle: RePEc:spr:eujhec:v:24:y:2023:i:4:d:10.1007_s10198-022-01496-0
    DOI: 10.1007/s10198-022-01496-0
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    References listed on IDEAS

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    More about this item

    Keywords

    Hospital payment; Risk-adjustment; Sex; Cardiac-related procedures;
    All these keywords.

    JEL classification:

    • H21 - Public Economics - - Taxation, Subsidies, and Revenue - - - Efficiency; Optimal Taxation
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination

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