Rankings of Unwarranted Variation in Healthcare Treatments

CentER Discussion Paper Series No. 2017-004

20 Pages Posted: 2 Feb 2017

See all articles by Herry Moes

Herry Moes

Seldon Management Advies

R.C.M. Brekelmans

Tilburg University - Tilburg University School of Economics and Management

Herbert Hamers

Tilburg University - Center for Economic Research (CentER); Tilburg University - Department of Econometrics & Operations Research

Fleur Hasaart

CZ

Date Written: February 2, 2017

Abstract

In this paper, we introduce a framework designed to identify and rank possible unwarranted variation of treatments in healthcare. The innovative aspect of this framework is a ranking procedure that aims to identify healthcare institutions where unwarranted variation is most severe, and diagnosis treatment combinations which appear to be the most sensitive to unwarranted variation. By adding a ranking procedure to our framework, we have taken our research a step beyond the existing literature. This ranking procedure is intended to assist health insurance companies in their search for violations, and to help find them more quickly, enabling more effective corrective and preventive actions on behalf of the healthcare institutions concerned.

Keywords: Unwarranted variation, Practice variation, Upcoding, Diagnosis-related group, Healthcare data, Health insurance

JEL Classification: I130

Suggested Citation

Moes, Herry and Brekelmans, R.C.M. and Hamers, Herbert and Hasaart, Fleur, Rankings of Unwarranted Variation in Healthcare Treatments (February 2, 2017). CentER Discussion Paper Series No. 2017-004. Available at SSRN: https://ssrn.com/abstract=2910316 or http://dx.doi.org/10.2139/ssrn.2910316

Herry Moes (Contact Author)

Seldon Management Advies ( email )

Markweg 13
Renkum, 6871 KW
Netherlands

R.C.M. Brekelmans

Tilburg University - Tilburg University School of Economics and Management ( email )

P.O. Box 90153
B 1029
5000 LE Tilburg
Netherlands
+31 13 466 8234 (Phone)

Herbert Hamers

Tilburg University - Center for Economic Research (CentER) ( email )

P.O. Box 90153
Tilburg, 5000 LE
Netherlands
+31 13 4666 2660 (Phone)

Tilburg University - Department of Econometrics & Operations Research

Tilburg, 5000 LE
Netherlands

Fleur Hasaart

CZ ( email )

Uhersk√Ĺ Brod
Czech Republic

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