Date and Time
July 11, 2007
1:30 PM - 3:00 PM

Availability
Open to the public
No RSVP required

Speaker
Jonas Schreyögg - Stanford University

Cross-country comparisons of costs and quality between hospitals are often made at the macro level. However, a high level of aggregation precludes adequate control for case-mix and does not allow for an in-depth analysis of differences. An alternative approach is to use patient-level data, which, however, are often unavailable. This paper aims to explore the feasibility of using patient-level data at the episode level as part of a multilevel approach to explain variation in costs and quality between hospitals in different settings. To do so, we developed a multilevel framework using similarly structured data for patients receiving treatment for acute myocardial infarction in German and US Veterans Health Administration hospitals. Our findings show that the sample of German hospitals included in our study were more cost-efficient and had lower in-hospital mortality. This finding was robust even after matching the samples according to co-morbidities and treatment characteristics. The differences between the two settings can be explained by a combination of differences in the input mix and in unit costs.