Ways to Improve Hospital Quality - A Health System Perspective; Comment on “Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies”
Wackers and colleagues’ scoping review provides an informative and well-structured overview of hospital-based case studies focusing on integrated hospital strategies that seek to improve quality, while reducing or containing costs. Wackers et al take a hospital level perspective and evaluate facilitators and barriers to the successful implementation of those hospital strategies. I complement the hospital level perspective of Wackers et al with an analysis from a health system perspective. Regulations at the superordinate system level might influence decisions at the hospital level that are relevant for costs and quality of care. In this commentary, I discuss how interventions at the system level might affect hospital quality. The results suggest that especially competition between hospitals, pay for performance (PfP) initiatives in combination with publication of quality information, but also greater experience of hospital staff (as proxied by the volume outcome relationship) may provide impulses for improving quality of care.
Wackers E, Stadhouders N, Heil A, Westert G, van Dulmen S, Jeurissen P. Hospitals bending the cost curve with increased quality: a scoping review into integrated hospital strategies. Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.168
Brekke KR, Canta C, Siciliani L, Straume OR. Hospital competition in a national health service: Evidence from a patient choice reform. J Health Econ. 2021;79:102509. doi:1016/j.jhealeco.2021.102509
Gaynor M, Town RJ. Competition in health care markets. In: Pauly M, McGuire T, Barros PP, Eds. Handbook of Health Economics. Vol. 9. North-Holland; 2011:499-637.
Gaynor M, Ho K, Town RJ. The industrial organization of health care markets. J Econ Lit.2015;53:235-284. doi:1257/jel.53.2.235
Kessler D, McClellan M. Is hospital competition socially wasteful? Q J Econ. 2000;115:577-615. doi:1162/003355300554863
Gowrisankaran G, Town R. Competition, payers, and hospital quality. Health Serv Res. 2003;38:1403-1422. doi:1111/j.1475-6773.2003.00185.x
Bijlsma M J, Koning P W, Shestalova V. The effect of competition on process and outcome quality of hospital care in the Netherlands. De Economist. 2013;161(2):121-155. doi:1007/s10645-013-9203-7
Cooper Z, Gibbons S, Skellern M. Does competition from private surgical centres improve public hospitals’ performance? evidence from the english national health service. J Public Econ. 2018;166:63–80. doi:1016/j.jpubeco.2018.08.002
Or Z, Roccoco E, Touré M, Bonastre J. Impact of competition versus centralisation of hospital care on process quality: a multilevel analysis of breast cancer surgery in France. Int J Health Policy Manag. 2022;11(4):459–469. doi:34172/ijhpm.2020.179
Avdic D, Moscelli G, Pilny A, Sriubaite I. Subjective and objective quality and choice of hospital: Evidence from maternal care services in Germany. J Health Econ. 2019;68:102229. doi:1016/j.jhealeco.2019.102229
Bundorf MK, Chun N, Goda GS, Kessler DP. Do markets respond to quality information? The case of fertility clinics. J Health Econ. 2009;28(3):718-727. doi:1016/j.jhealeco.2009.01.001
Wübker A, Sauerland D, Wübker A. Beeinflussen bessere Qualitätsinformationen die Krankenhauswahl in Deutschland?/Does Better Quality Information Affect Hospital Choice in Germany? Jahrb Natl Okon Stat. 2010;230(4):467-490. doi:1515/jbnst-2010-0407
Eijkenaar F, Emmert M, Scheppach M, Schöffski O. Effects of pay for performance in health care: a systematic review of systematic reviews. Health Policy. 2013;110(2-3):115-130. doi:1016/j.healthpol.2013.01.008
Lindenauer P K, Remus D, Roman S, et al. Public reporting and pay for performance in hospital quality improvement. N Engl J Med. 2007;356(5):486-496. doi:1056/NEJMsa064964
Wübker A., Wuckel C. The impact of private for-profit hospital ownership on costs and quality of care–evidence from Germany. CESifo Econ Stud. 2019;65(4):373-401. doi:1093/cesifo/ifz005
Bergman M A, Johansson P, Lundberg S, Spagnolo G . Privatization and Quality: Evidence from Elderly Care in Sweden, J Health Econ. 2016;49:109-119. doi:1016/j.jhealeco.2016.06.010
Hentschker C, Mennicken, R. The Volume-Outcome Relationship Revisited: Practice Indeed Makes Perfect. Health Serv Res. 2018;53(1):15–34. doi:1111/1475-6773.12696
Avdic D. Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden. J Health Econ. 2016;48: 44-60. doi:1016/j.jhealeco.2016.02.002
Wuebker, A. (2023). Ways to Improve Hospital Quality - A Health System Perspective; Comment on “Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies”. International Journal of Health Policy and Management, 12(Issue 1), 1-3. doi: 10.34172/ijhpm.2022.7422
MLA
Ansgar Wuebker. "Ways to Improve Hospital Quality - A Health System Perspective; Comment on “Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies”". International Journal of Health Policy and Management, 12, Issue 1, 2023, 1-3. doi: 10.34172/ijhpm.2022.7422
HARVARD
Wuebker, A. (2023). 'Ways to Improve Hospital Quality - A Health System Perspective; Comment on “Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies”', International Journal of Health Policy and Management, 12(Issue 1), pp. 1-3. doi: 10.34172/ijhpm.2022.7422
VANCOUVER
Wuebker, A. Ways to Improve Hospital Quality - A Health System Perspective; Comment on “Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies”. International Journal of Health Policy and Management, 2023; 12(Issue 1): 1-3. doi: 10.34172/ijhpm.2022.7422