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The influence of changes in activity-based financing on hospital readmissions for the elderly
Nordic Journal of Health Economics
View Archive Info| Field | Value | |
| Title |
The influence of changes in activity-based financing on hospital readmissions for the elderly
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| Creator |
Yin, Jun; Akershus University Hospital, University of Oslo
Dahl, Fredrik A.; Akershus University Hospital Hagen, Terje P.; University of Oslo Lurås, Hilde; Akershus University Hospital, University of Oslo |
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| Subject |
hospitals, elderly, activity-based financing, readmission, cox regression model
hospitals, elderly, activity-based financing, readmission, cox regression model H51 |
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| Description |
Activity-based financing of Norwegian hospitals was implemented in 1997. An earlier study shows that when the activity-based component increases, the average length of stay for the elderly is reduced. If this reduction entails premature discharge, an increased activity-based component may have the undesirable side effect of increasing readmission rates. Yearly the Norwegian government decides the size of the activity-based component, and all hospitals face the same size. In this paper, we investigate whether the level of activity-based financing is associated with the readmission rates for acute-care patients above 70 years of age. The sample consisted of 468 010 hospital admissions among elderly patients in the period from 2000 to 2007. Using repeated cross-sectional data extracted from the Norwegian Patient Registry, a Cox regression model was used to estimate factors that may influence the hazard rate of a readmission within 30 days. The overall 30-day readmission rate was 6.6%. The results demonstrate that the activity-based component had no significant effect on the readmission rate. Patient-specific factors such as age, gender, diagnoses, comorbidities, as well as the time trend, were important predictors of readmission rates. We also found a statistically significant random effect of hospitals, although this effect was less substantial than the impact of patient characteristics. Our results show that the effect of the activity-based component on the readmission rate was negligible when it varied between 40% and 60%.Published: Online May 2016. In print August 2016.
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| Publisher |
University of Oslo
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| Contributor |
the Foundation for Health Services Research (HELTEF)
Kann Inger Cathrine, Jorun Rugkåsa, Akershus University Hospital |
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| Date |
2016-08-13
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| Type |
info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion Peer-reviewed Article |
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| Format |
application/pdf
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| Identifier |
https://www.journals.uio.no/index.php/NJHE/article/view/992
10.5617/njhe.992 |
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| Source |
Nordic Journal of Health Economics; Vol 4, No 2 (2016): Nordic Journal of Health Economics; pp. 72-81
1892-9710 1892-9729 |
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| Language |
eng
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| Relation |
https://www.journals.uio.no/index.php/NJHE/article/view/992/3073
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| Rights |
Authors who publish with this journal agree to the following terms:Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
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