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Differences In Length Of Stay For Hip Replacement Between Public Hospitals, Specialised Treatment Centres And Private Providers: Selection Or Efficiency?

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  • Luigi Siciliani
  • Peter Sivey
  • Andrew Street

Abstract

We investigate differences in patients’ length of stay between National Health Service (NHS) public hospitals, specialised public treatment centres and private treatment centres that provide elective (non‐emergency) hip replacement to publicly funded patients. We find that the specialised public treatment centres and private treatment centres have, on average, respectively 18% and 40% shorter length of stay compared with NHS public hospitals, even after controlling for differences in age, gender, number and type of diagnoses, deprivation and regional variation. Therefore, we interpret such differences as because of efficiency as opposed to selection of less complex patients. Quantile regression suggests that the proportional differences between different provider types are larger at the higher conditional quantiles of length of stay. Copyright © 2012 John Wiley & Sons, Ltd.

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  • Luigi Siciliani & Peter Sivey & Andrew Street, 2013. "Differences In Length Of Stay For Hip Replacement Between Public Hospitals, Specialised Treatment Centres And Private Providers: Selection Or Efficiency?," Health Economics, John Wiley & Sons, Ltd., vol. 22(2), pages 234-242, February.
    • Handle: RePEc:wly:hlthec:v:22:y:2013:i:2:p:234-242
    DOI: 10.1002/hec.1826
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    2. Brendan Walsh & Seán Lyons & Samantha Smith & Maev‐Ann Wren & James Eighan & Edgar Morgenroth, 2020. "Does formal home care reduce inpatient length of stay?," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1620-1636, December.
    3. Kim, Sun Jung & Park, Eun-Cheol & Jang, Sung In & Lee, Minjee & Kim, Tae Hyun, 2013. "An analysis of the inpatient charge and length of stay for patients with joint diseases in Korea: Specialty versus small general hospitals," Health Policy, Elsevier, vol. 113(1), pages 93-99.
    4. Martin Chalkley, 2018. "Private Provision of Publicly Funded Health Care: The Economics of Ownership," Briefing 002055, Office of Health Economics.
    5. Cheng, Terence C. & Haisken-DeNew, John P. & Yong, Jongsay, 2015. "Cream skimming and hospital transfers in a mixed public-private system," Social Science & Medicine, Elsevier, vol. 132(C), pages 156-164.
    6. 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.
    7. Walter Beckert & Elaine Kelly, 2021. "Divided by choice? For‐profit providers, patient choice and mechanisms of patient sorting in the English National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 820-839, April.
    8. Yohann Moanahere Chiu & Fateh Chebana & Belkacem Abdous & Diane Bélanger & Pierre Gosselin, 2021. "Cardiovascular Health Peaks and Meteorological Conditions: A Quantile Regression Approach," IJERPH, MDPI, vol. 18(24), pages 1-14, December.
    9. Nils Gutacker & Andrew Street, 2015. "Multidimensional performance assessment using dominance criteria," Working Papers 115cherp, Centre for Health Economics, University of York.
    10. Nils Gutacker & Andrew Street, 2018. "Multidimensional performance assessment of public sector organisations using dominance criteria," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 13-27, February.
    11. Fletcher, Simon & Eddama, Oya & Anderson, Michael & Meacock, Rachel & Wattal, Vasudha & Allen, Pauline & Peckham, Stephen, 2024. "The impact of NHS outsourcing of elective care to the independent sector on outcomes for patients, healthcare professionals and the United Kingdom health care system: a rapid narrative review of liter," LSE Research Online Documents on Economics 125828, London School of Economics and Political Science, LSE Library.
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    13. Yang, Ou & Chan, Marc K. & Cheng, Terence C. & Yong, Jongsay, 2020. "Cream skimming: Theory and evidence from hospital transfers and capacity utilization," Journal of Economic Behavior & Organization, Elsevier, vol. 173(C), pages 68-87.

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