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Individual and Regional-level Factors Contributing to Variation in Length of Stay After Cerebral Infarction in Six European Countries.
Peltola, Mikko; Seppälä, Timo T; Malmivaara, Antti; Belicza, Éva; Numerato, Dino; Goude, Fanny; Fletcher, Eilidh; Heijink, Richard.
Afiliação
  • Peltola M; Centre for Health and Social Economics CHESS, National Institute for Health and Welfare, Helsinki, Finland.
  • Seppälä TT; Centre for Health and Social Economics CHESS, National Institute for Health and Welfare, Helsinki, Finland.
  • Malmivaara A; Centre for Health and Social Economics CHESS, National Institute for Health and Welfare, Helsinki, Finland.
  • Belicza É; Semmelweis University, Budapest, Hungary.
  • Numerato D; Centre for Research on Health and Social Care Management, Bocconi University, Milano, Italy.
  • Goude F; Department of Sociology, Faculty of Social Sciences, Charles University, Prague, The Czech Republic.
  • Fletcher E; Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
  • Heijink R; National Health Services, Edinburgh, Scotland.
Health Econ ; 24 Suppl 2: 38-52, 2015 Dec.
Article em En | MEDLINE | ID: mdl-26633867
ABSTRACT
Using patient-level data for cerebral infarction cases in 2007, gathered from Finland, Hungary, Italy, the Netherlands, Scotland and Sweden, we studied the variation in risk-adjusted length of stay (LoS) of acute hospital care and 1-year mortality, both within and between countries. In addition, we analysed the variance of LoS and associations of selected regional-level factors with LoS and 1-year mortality after cerebral infarction. The data show that LoS distributions are surprisingly different across countries and that there is significant deviation in the risk-adjusted regional-level LoS in all of the countries studied. We used negative binomial regression to model the individual-level LoS, and random intercept models and ordinary least squares regression for the regional-level analysis of risk-adjusted LoS, variance of LoS, 1-year risk-adjusted mortality and crude mortality for a period of 31-365 days. The observed variations between regions and countries in both LoS and mortality were not fully explained by either patient-level or regional-level factors. The results indicate that there may exist potential for efficiency gains in acute hospital care of cerebral infarction and that healthcare managers could learn from best practices.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infarto Cerebral / Tempo de Internação Tipo de estudo: Diagnostic_studies / Guideline / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Health Econ Assunto da revista: SERVICOS DE SAUDE Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Finlândia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infarto Cerebral / Tempo de Internação Tipo de estudo: Diagnostic_studies / Guideline / Prognostic_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Health Econ Assunto da revista: SERVICOS DE SAUDE Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Finlândia