Quality and resource efficiency in hospital service provision: A geoadditive stochastic frontier analysis of stroke quality of care in Germany

Christoph Pross, Christoph Strumann, Alexander Geissler*, Helmut Herwartz, Nadja Klein

*Corresponding author for this work

Abstract

We specify a Bayesian, geoadditive Stochastic Frontier Analysis (SFA) model to assess hospital performance along the dimensions of resources and quality of stroke care in German hospitals. With 1,100 annual observations and data from 2006 to 2013 and risk-adjusted patient volume as output, we introduce a production function that captures quality, resource inputs, hospital inefficiency determinants and spatial patterns of inefficiencies. With high relevance for hospital management and health system regulators, we identify performance improvement mechanisms by considering marginal effects for the average hospital. Specialization and certification can substantially reduce mortality. Regional and hospital-level concentration can improve quality and resource efficiency. Finally, our results demonstrate a trade-off between quality improvement and resource reduction and substantial regional variation in efficiency.

Original languageEnglish
Article numbere0203017
JournalPLoS ONE
Volume13
Issue number9
ISSN1553-7390
DOIs
Publication statusPublished - 01.09.2018

Fingerprint

Dive into the research topics of 'Quality and resource efficiency in hospital service provision: A geoadditive stochastic frontier analysis of stroke quality of care in Germany'. Together they form a unique fingerprint.

Cite this