Costs and Quality of Hospitals in Different Health Care Systems: A Multilevel Approach with Propensity Score Matching

Health Economics, 2010

16 Pages Posted: 8 Apr 2010 Last revised: 8 Jul 2010

See all articles by Jonas Schreyoegg

Jonas Schreyoegg

University of Hamburg - Faculty of Economics and Business Administration

Tom Stargardt

University of Hamburg

Oliver Tiemann

University of Hamburg - Faculty of Economics and Business Administration

Date Written: January 18, 2010

Abstract

Cross-country comparisons of costs and quality between hospitals are often made at the macro level. The goal of this study was to explore methods to compare micro-level data from hospitals in different health care systems. To do so, we developed a multi-level framework in combination with a propensity score matching technique using similarly structured data for patients receiving treatment for acute myocardial infarction in German and US Veterans Health Administration hospitals. Our case study shows important differences in results between multi-level regressions based on matched and unmatched samples. We conclude that propensity score matching techniques are an appropriate way to deal with the usual baseline imbalances across the samples from different countries. Multi-level models are recommendable to consider the clustered structure of the data when patient-level data from different hospitals and health care systems are compared. The results provide an important justification for exploring new ways in performing health system comparisons.

Keywords: multilevel models, propensity score matching, hospital costs, acute myocardial infarction

Suggested Citation

Schreyoegg, Jonas and Stargardt, Tom and Tiemann, Oliver, Costs and Quality of Hospitals in Different Health Care Systems: A Multilevel Approach with Propensity Score Matching (January 18, 2010). Health Economics, 2010. Available at SSRN: https://ssrn.com/abstract=1574124

Jonas Schreyoegg (Contact Author)

University of Hamburg - Faculty of Economics and Business Administration ( email )

Von-Melle-Park 5
Hamburg, 20146
Germany

Tom Stargardt

University of Hamburg ( email )

Hamburg Center for Health Economics
Esplanade 36
Hamburg, 20354
Germany

Oliver Tiemann

University of Hamburg - Faculty of Economics and Business Administration ( email )

Von-Melle-Park 5
Hamburg, 20146
Germany

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