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Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007

BACKGROUND: This paper analyses the volume-outcome relationship and the effects of minimum volume regulations in the German hospital sector. METHODS: We use a full sample of administrative data from the unselected, complete German hospital population for the years 2005 to 2007. We apply regression m...

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Autores principales: Hentschker, Corinna, Mennicken, Roman, Reifferscheid, Antonius, Wasem, Jürgen, Wübker, Ansgar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755587/
https://www.ncbi.nlm.nih.gov/pubmed/30259207
http://dx.doi.org/10.1186/s13561-018-0204-8
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author Hentschker, Corinna
Mennicken, Roman
Reifferscheid, Antonius
Wasem, Jürgen
Wübker, Ansgar
author_facet Hentschker, Corinna
Mennicken, Roman
Reifferscheid, Antonius
Wasem, Jürgen
Wübker, Ansgar
author_sort Hentschker, Corinna
collection PubMed
description BACKGROUND: This paper analyses the volume-outcome relationship and the effects of minimum volume regulations in the German hospital sector. METHODS: We use a full sample of administrative data from the unselected, complete German hospital population for the years 2005 to 2007. We apply regression methods to analyze the association between volume and hospital quality. We measure hospital quality with a binary variable, which indicates whether the patient has died in hospital. Using simulation techniques we examine the impact of the minimum volume regulations on the accessibility of hospital services. RESULTS: We find a highly significant negative relationship between case volume and mortality for complex interventions at the pancreas and oesophagus as well as for knee replacement. For liver, kidney and stem cell transplantation as well as for CABG we could not find a strong association between volume and quality. Access to hospital care is only moderately affected by minimum volume regulations. CONCLUSION: The effectiveness of minimum volume regulations depends on the type of intervention. Depending on the type of intervention, quality gains can be expected at the cost of slightly decreased access to care.
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spelling pubmed-67555872019-09-26 Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007 Hentschker, Corinna Mennicken, Roman Reifferscheid, Antonius Wasem, Jürgen Wübker, Ansgar Health Econ Rev Research BACKGROUND: This paper analyses the volume-outcome relationship and the effects of minimum volume regulations in the German hospital sector. METHODS: We use a full sample of administrative data from the unselected, complete German hospital population for the years 2005 to 2007. We apply regression methods to analyze the association between volume and hospital quality. We measure hospital quality with a binary variable, which indicates whether the patient has died in hospital. Using simulation techniques we examine the impact of the minimum volume regulations on the accessibility of hospital services. RESULTS: We find a highly significant negative relationship between case volume and mortality for complex interventions at the pancreas and oesophagus as well as for knee replacement. For liver, kidney and stem cell transplantation as well as for CABG we could not find a strong association between volume and quality. Access to hospital care is only moderately affected by minimum volume regulations. CONCLUSION: The effectiveness of minimum volume regulations depends on the type of intervention. Depending on the type of intervention, quality gains can be expected at the cost of slightly decreased access to care. Springer Berlin Heidelberg 2018-09-26 /pmc/articles/PMC6755587/ /pubmed/30259207 http://dx.doi.org/10.1186/s13561-018-0204-8 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Hentschker, Corinna
Mennicken, Roman
Reifferscheid, Antonius
Wasem, Jürgen
Wübker, Ansgar
Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007
title Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007
title_full Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007
title_fullStr Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007
title_full_unstemmed Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007
title_short Volume-outcome relationship and minimum volume regulations in the German hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007
title_sort volume-outcome relationship and minimum volume regulations in the german hospital sector – evidence from nationwide administrative hospital data for the years 2005–2007
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755587/
https://www.ncbi.nlm.nih.gov/pubmed/30259207
http://dx.doi.org/10.1186/s13561-018-0204-8
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