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Does size matter? The impact of caseload and expertise concentration on AMI 30-day mortality—A comparison across 10 OECD countries

Author

Listed:
  • Benoît Lalloué

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, IGR - Institut Gustave Roussy, EHESP - École des Hautes Études en Santé Publique [EHESP])

  • Michael Padget

    (OCDE - Organisation de Coopération et de Développement Economiques = Organisation for Economic Co-operation and Development)

  • Etienne Minvielle

    (EA MOS - EA Management des Organisations de Santé - EHESP - École des Hautes Études en Santé Publique [EHESP] - PRES Sorbonne Paris Cité, i3-CRG - Centre de recherche en gestion i3 - X - École polytechnique - IP Paris - Institut Polytechnique de Paris - Université Paris-Saclay - I3 - Institut interdisciplinaire de l’innovation - CNRS - Centre National de la Recherche Scientifique, IGR - Institut Gustave Roussy, EHESP - École des Hautes Études en Santé Publique [EHESP])

  • Niek Klazinga

    (OCDE - Organisation de Coopération et de Développement Economiques = Organisation for Economic Co-operation and Development)

  • Ian Brownwood

    (OCDE - Organisation de Coopération et de Développement Economiques = Organisation for Economic Co-operation and Development)

Abstract

Objective To examine the variability of hospital performance within and across countries, using 30-day acute myocardial infarction (AMI) mortality, and to study the impact of hospital characteristics on performance. Study setting Hospital-level adjusted risk standardized mortality rates (RSMR) and hospital characteristics were collected from 10 OECD and two collaborating countries including 1,163 hospitals. Study design Associations between RSMR and hospital characteristics were studied using univariate and multivariate linear regressions. Clusters of hospitals were created using hierarchical clustering and mortality compared using linear regression. Findings Wide variation between countries was found for RSMR and hospital characteristics. Regression models showed large country effects. A high volume of AMI admission was associated with lower RSMR in a model using a restricted number of hospital characteristics (−0.83, p

Suggested Citation

  • Benoît Lalloué & Michael Padget & Etienne Minvielle & Niek Klazinga & Ian Brownwood, 2019. "Does size matter? The impact of caseload and expertise concentration on AMI 30-day mortality—A comparison across 10 OECD countries," Post-Print hal-02089667, HAL.
    • Handle: RePEc:hal:journl:hal-02089667
    DOI: 10.1016/j.healthpol.2019.03.007
    Note: View the original document on HAL open archive server: https://hal.science/hal-02089667v1
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    Cited by:

    1. D'Aniello, Luca & Spano, Maria & Cuccurullo, Corrado & Aria, Massimo, 2022. "Academic Health Centers’ configurations, scientific productivity, and impact: Insights from the Italian setting," Health Policy, Elsevier, vol. 126(12), pages 1317-1323.

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