Format du dépôt |
Fichier |
Type de dépôt |
Article dans une revue |
Titre |
en
What underlies the observed hospital volume- outcome relationship?
|
Résumé |
en
Studies of the hospital volume-outcome relationship have highlighted that a greater volume activity improves patient outcomes. While this finding has been known for years in health services research, most studies to date have failed to delve into what underlies this relationship. This study aimed to shed light on the basis of the hospital volume effect by comparing treatment modalities for epithelial ovarian carcinoma patients. Hospital volume activity was instrumented by the distance from patients' homes to their hospital, the population density, and the median net income of patient municipalities. We found that higher volume hospitals appear to more often make the right decisions in regard to how to treat patients, which contributes to the positive impact of hospital volume activities on patient outcomes. Based on our parameter estimates, we found that the rate of complete tumor resection would increase by 10% with centralized care, and by 6% if treatment decisions were coordinated by high volume centers compared to the ongoing organization of care. In both scenarios, the use of neoadjuvant chemotherapy would increase by 10%. As volume alone is an imperfect correlate of quality, policy makers need to know what volume is a proxy for in order to devise volume-based policies.
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Auteur(s)
|
Marius Huguet
1, 2
, Xavier Joutard
3, 4
, Isabelle Ray-Coquard
2
, Lionel Perrier
5, 2
1
CIS - MINES -
Centre Ingénierie Santé, Saint-Étienne
( 544553 )
- France
2
Centre Léon Bérard [Lyon]
( 20549 )
- 28, rue Laennec 69373 LYON Cedex 08
- France
3
LEST -
Laboratoire d'Economie et de Sociologie du Travail
( 839 )
- 35 Avenue Jules Ferry - 13626 Aix en Provence cedex 1
- France
-
Aix Marseille Université UMR7317 / UMR6123 / UPR9059 / ERS99 / UPR7511 ( 198056 )
;
-
Centre National de la Recherche Scientifique UMR7317 / UMR6123 / UPR9059 / ERS99 / UPR7511 ( 441569 )
4
OFCE -
Observatoire français des conjonctures économiques (Sciences Po)
( 250936 )
- 10 place de Catalogne - 75014 Paris
- France
5
GATE Lyon Saint-Étienne -
Groupe d'Analyse et de Théorie Economique Lyon - Saint-Etienne
( 1169842 )
- 93, chemin des Mouilles 69130 Écully 6, rue Basse des Rives 42023 Saint-Étienne cedex 02
- France
-
École normale supérieure de Lyon ( 6818 )
;
-
Université Lumière - Lyon 2 ( 33804 )
;
-
Université Jean Monnet - Saint-Étienne ( 300284 )
;
-
Centre National de la Recherche Scientifique UMR5824 ( 441569 )
|
Langue du document |
Anglais
|
Nom de la revue |
|
Vulgarisation |
Non
|
Comité de lecture |
Oui
|
Audience |
Internationale
|
Date de publication |
2022
|
Date de publication électronique |
2022-01-14
|
Licence |
Paternité
|
URL éditeur |
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-07449-2
|
Volume |
22
|
Numéro |
70
|
Domaine(s) |
-
Sciences de l'Homme et Société/Economies et finances
|
Mots-clés (JEL) |
-
C - Mathematical and Quantitative Methods/C.C3 - Multiple or Simultaneous Equation Models • Multiple Variables/C.C3.C31 - Cross-Sectional Models • Spatial Models • Treatment Effect Models • Quantile Regressions • Social Interaction Models
-
I - Health, Education, and Welfare/I.I1 - Health/I.I1.I11 - Analysis of Health Care Markets
-
I - Health, Education, and Welfare/I.I1 - Health/I.I1.I18 - Government Policy • Regulation • Public Health
-
L - Industrial Organization/L.L1 - Market Structure, Firm Strategy, and Market Performance/L.L1.L11 - Production, Pricing, and Market Structure • Size Distribution of Firms
|
Référence interne |
-
Working paper GATE 2018-09
|
Mots-clés |
en
Volume outcome relationship, France, Epithelial Ovarian Cancer, Instrumental variable, Organization of care, Care pathway, Learning effect, Centralization of care
|
DOI |
10.1186/s12913-021-07449-2 |
PubMed Central |
PMC8760746 |