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International Journal of Health Economics and Management

Open Access 21-03-2024 | Research article

Analyzing the 20-year declining trend of hospital length-of-stay in European countries with different healthcare systems and reimbursement models

Authors: Davide Golinelli, Francesco Sanmarchi, Fabrizio Toscano, Andrea Bucci, Nicola Nante

Published in: International Journal of Health Economics and Management

Abstract

The study aims to investigate the last 20-year (2000–2019) of hospital length of stay (LOS) trends and their association with different healthcare systems (HS) among 25 European countries. A panel dataset was created using secondary data from Eurostat and Global Burden of Disease study databases, with dependent and control variables aggregated at the national level over a period of 20 years. A time trend analysis was conducted using a weighted least squares model for panel data to investigate the association between LOS, HS models [National Health Service (NHS), National Health Insurance, Social Health Insurance (SHI), and Etatist Social Health Insurance], healthcare reimbursement schemes [Prospective Global Budget (PGB), Diagnosis Related Groups (DRG), and Procedure Service Payment (PSP)], and control variables. The study showed a reduction of average LOS from 9.20 days in 2000 to 7.24 in 2019. SHI was associated with a lower LOS compared to NHS (b = − 0.6327, p < 0.05). Both DRG (b = 1.2399, p < 0.05) and PSP (b = 1.1677, p < 0.05) reimbursement models were positively associated with LOS compared to PGB. Our results confirmed the downward trend of LOS in the last 20 years, its multifactorial nature, and the influence of the SHI model of HS. This could be due to the financial incentives present in fee-for-service payment models and the role of competition in creating a market for healthcare services. These results offer insight into the factors influencing healthcare utilization and can inform the design of more effective, efficient, and sustainable HS.

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Title: Analyzing the 20-year declining trend of hospital length-of-stay in European countries with different healthcare systems and reimbursement models
Authors: Davide Golinelli
Francesco Sanmarchi
Fabrizio Toscano
Andrea Bucci
Nicola Nante
Publication date: 21-03-2024
Publisher: Springer US
Published in: International Journal of Health Economics and Management
Print ISSN: 2199-9023
Electronic ISSN: 2199-9031
DOI: https://doi.org/10.1007/s10754-024-09369-0

Keynote webinar | Spotlight on medication adherence

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Analyzing the 20-year declining trend of hospital length-of-stay in European countries with different healthcare systems and reimbursement models

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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