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Payments and quality of care in private for-profit and public hospitals in Greece

BACKGROUND: Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public se...

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Autores principales: Kondilis, Elias, Gavana, Magda, Giannakopoulos, Stathis, Smyrnakis, Emmanouil, Dombros, Nikolaos, Benos, Alexis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199237/
https://www.ncbi.nlm.nih.gov/pubmed/21943020
http://dx.doi.org/10.1186/1472-6963-11-234
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author Kondilis, Elias
Gavana, Magda
Giannakopoulos, Stathis
Smyrnakis, Emmanouil
Dombros, Nikolaos
Benos, Alexis
author_facet Kondilis, Elias
Gavana, Magda
Giannakopoulos, Stathis
Smyrnakis, Emmanouil
Dombros, Nikolaos
Benos, Alexis
author_sort Kondilis, Elias
collection PubMed
description BACKGROUND: Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged. METHODS: Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003. RESULTS: PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities. CONCLUSIONS: In a mixed healthcare system, such as that in Greece, significant performance differences were observed between PFP and public hospitals. Close monitoring of healthcare provision by hospital ownership type will be essential to permit evidence-based decisions on the future of the public/private mix in terms of healthcare provision.
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spelling pubmed-31992372011-10-24 Payments and quality of care in private for-profit and public hospitals in Greece Kondilis, Elias Gavana, Magda Giannakopoulos, Stathis Smyrnakis, Emmanouil Dombros, Nikolaos Benos, Alexis BMC Health Serv Res Research Article BACKGROUND: Empirical evidence on how ownership type affects the quality and cost of medical care is growing, and debate on these topics is ongoing. Despite the fact that the private sector is a major provider of hospital services in Greece, little comparative information on private versus public sector hospitals is available. The aim of the present study was to describe and compare the operation and performance of private for-profit (PFP) and public hospitals in Greece, focusing on differences in nurse staffing rates, average lengths of stay (ALoS), and Social Health Insurance (SHI) payments for hospital care per patient discharged. METHODS: Five different datasets were prepared and analyzed, two of which were derived from information provided by the National Statistical Service (NSS) of Greece and the other three from data held by the three largest SHI schemes in the country. All data referred to the 3-year period from 2001 to 2003. RESULTS: PFP hospitals in Greece are smaller than public hospitals, with lower patient occupancy, and have lower staffing rates of all types of nurses and highly qualified nurses compared with public hospitals. Calculation of ALoS using NSS data yielded mixed results, whereas calculations of ALoS and SHI payments using SHI data gave results clearly favoring the public hospital sector in terms of cost-efficiency; in all years examined, over all specialties and all SHI schemes included in our study, unweighted ALoS and SHI payments for hospital care per discharge were higher for PFP facilities. CONCLUSIONS: In a mixed healthcare system, such as that in Greece, significant performance differences were observed between PFP and public hospitals. Close monitoring of healthcare provision by hospital ownership type will be essential to permit evidence-based decisions on the future of the public/private mix in terms of healthcare provision. BioMed Central 2011-09-23 /pmc/articles/PMC3199237/ /pubmed/21943020 http://dx.doi.org/10.1186/1472-6963-11-234 Text en Copyright ©2011 Kondilis et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Kondilis, Elias
Gavana, Magda
Giannakopoulos, Stathis
Smyrnakis, Emmanouil
Dombros, Nikolaos
Benos, Alexis
Payments and quality of care in private for-profit and public hospitals in Greece
title Payments and quality of care in private for-profit and public hospitals in Greece
title_full Payments and quality of care in private for-profit and public hospitals in Greece
title_fullStr Payments and quality of care in private for-profit and public hospitals in Greece
title_full_unstemmed Payments and quality of care in private for-profit and public hospitals in Greece
title_short Payments and quality of care in private for-profit and public hospitals in Greece
title_sort payments and quality of care in private for-profit and public hospitals in greece
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199237/
https://www.ncbi.nlm.nih.gov/pubmed/21943020
http://dx.doi.org/10.1186/1472-6963-11-234
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