Nothing Special   »   [go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v27y2018i2p266-281.html
   My bibliography  Save this article

How do hospital‐specialty characteristics influence health system responsiveness? An empirical evaluation of in‐patient care in the Italian region of Emilia‐Romagna

Author

Listed:
  • Gianluca Fiorentini
  • Silvana Robone
  • Rossella Verzulli
Abstract
Studies of health system responsiveness mostly focus on the demand side by investigating the association between sociodemographic characteristics of patients and their reported level of responsiveness. However, little is known about the influence of supply‐side factors. This paper addresses that research gap by analysing the role of hospital‐specialty characteristics in explaining variations in patients' evaluation of responsiveness from a sample of about 38,700 in‐patients treated in public hospitals within the Italian Region of Emilia‐Romagna. The analysis is carried out by adopting a 2‐step procedure. First, we use patients' self‐reported data to derive 5 measures of responsiveness at the hospital‐specialty level. By estimating a generalised ordered probit model, we are able to correct for variations in individual reporting behaviour due to the health status of patients and their experience of being in pain. Second, we run cross‐sectional regressions to investigate the association between patients' responsiveness and potential supply‐side drivers, including waiting times, staff workload, the level of spending on non‐clinical facilities, the level of spending on staff education and training, and the proportion of staff expenditure between nursing and administrative staff. Results suggest that responsiveness is to some extent influenced by the supply‐side drivers considered.

Suggested Citation

  • Gianluca Fiorentini & Silvana Robone & Rossella Verzulli, 2018. "How do hospital‐specialty characteristics influence health system responsiveness? An empirical evaluation of in‐patient care in the Italian region of Emilia‐Romagna," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 266-281, February.
    • Handle: RePEc:wly:hlthec:v:27:y:2018:i:2:p:266-281
    DOI: 10.1002/hec.3540
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3540
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.3540?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Huber, John D. & Stanig, Piero, 2011. "Church-state separation and redistribution," Journal of Public Economics, Elsevier, vol. 95(7), pages 828-836.
    2. Franco Peracchi & Claudio Rossetti, 2013. "The heterogeneous thresholds ordered response model: identification and inference," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 176(3), pages 703-722, June.
    3. Rice, N & Robone, S & Smith, P.C, 2008. "International Comparison of Public Sector Performance: The Use of Anchoring Vignettes to adjust Self-Reported Data," Health, Econometrics and Data Group (HEDG) Working Papers 08/28, HEDG, c/o Department of Economics, University of York.
    4. Nigel Rice & Silvana Robone & Peter Smith, 2011. "Analysis of the validity of the vignette approach to correct for heterogeneity in reporting health system responsiveness," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 141-162, April.
    5. Fiorentini, Gianluca & Ragazzi, Giovanni & Robone, Silvana, 2015. "Are bad health and pain making us grumpy? An empirical evaluation of reporting heterogeneity in rating health system responsiveness," Social Science & Medicine, Elsevier, vol. 144(C), pages 48-58.
    6. Robone, S & Rice, N & Smith, P, 2010. "Health systems’ responsiveness and its characteristics: a cross-country comparative analysis," Health, Econometrics and Data Group (HEDG) Working Papers 10/29, HEDG, c/o Department of Economics, University of York.
    7. Röttger, Julia & Blümel, Miriam & Fuchs, Sabine & Busse, Reinhard, 2014. "Assessing the responsiveness of chronic disease care - Is the World Health Organization's concept of health system responsiveness applicable?," Social Science & Medicine, Elsevier, vol. 113(C), pages 87-94.
    8. Andrew M. Jones & Stefanie Schurer, 2011. "How does heterogeneity shape the socioeconomic gradient in health satisfaction?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 26(4), pages 549-579, June.
    9. Michael Baker & Mark Stabile & Catherine Deri, 2004. "What Do Self-Reported, Objective, Measures of Health Measure?," Journal of Human Resources, University of Wisconsin Press, vol. 39(4).
    10. Stephen Pudney & Michael Shields, 2000. "Gender, race, pay and promotion in the British nursing profession: estimation of a generalized ordered probit model," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 15(4), pages 367-399.
    11. Nigel Rice & Silvana Robone & Peter C. Smith, 2012. "Vignettes and health systems responsiveness in cross‐country comparative analyses," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 337-369, April.
    12. repec:cup:apsrev:v:98:y:2004:i:01:p:191-207_00 is not listed on IDEAS
    13. S. Robone & G. Fiorentini & M. A. Nicoli & S. Rodella, 2014. "La responsiveness dei sistemi sanitari: un analisi empirica sull assistenza ospedaliera nel Servizio Sanitario Regionale dell Emilia Romagna," Working Papers wp934, Dipartimento Scienze Economiche, Universita' di Bologna.
    14. Huber, John D. & Stanig, Piero, 2011. "Church-state separation and redistribution," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 828-836, August.
    15. Nicolas Sirven & Brigitte Santos-Eggimann & Jacques Spagnoli, 2012. "Comparability of Health Care Responsiveness in Europe," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 105(2), pages 255-271, January.
    16. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    17. Laudicella, Mauro & Olsen, Kim Rose & Street, Andrew, 2010. "Examining cost variation across hospital departments-a two-stage multi-level approach using patient-level data," Social Science & Medicine, Elsevier, vol. 71(10), pages 1872-1881, November.
    18. Fally, Thibault & Paillacar, Rodrigo & Terra, Cristina, 2010. "Economic geography and wages in Brazil: Evidence from micro-data," Journal of Development Economics, Elsevier, vol. 91(1), pages 155-168, January.
    19. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 82(2), pages 457-489.
    20. Andrew Street & Conrad Kobel & Thomas Renaud & Josselin Thuilliez & ON BEHALF OF THE EURODRG GROUP, 2012. "How Well Do Diagnosis‐Related Groups Explain Variations In Costs Or Length Of Stay Among Patients And Across Hospitals? Methods For Analysing Routine Patient Data," Health Economics, John Wiley & Sons, Ltd., vol. 21(S2), pages 6-18, August.
    21. Qing Luo & Qi Wang & Zuxun Lu & Junan Liu, 2013. "Evaluation of Responsiveness of Community Health Services in Urban China: A Quantitative Study in Wuhan City," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-8, May.
    22. Matteo Lippi Bruni & Irene Mammi, 2017. "Spatial effects in hospital expenditures: A district level analysis," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 63-77, September.
    23. Valentine, Nicole & Verdes-Tennant, Emese & Bonsel, Gouke, 2015. "Health systems' responsiveness and reporting behaviour: Multilevel analysis of the influence of individual-level factors in 64 countries," Social Science & Medicine, Elsevier, vol. 138(C), pages 152-160.
    24. Teresa Bago d’Uva & Maarten Lindeboom & Owen O’Donnell & Eddy van Doorslaer, 2011. "Slipping Anchor?: Testing the Vignettes Approach to Identification and Correction of Reporting Heterogeneity," Journal of Human Resources, University of Wisconsin Press, vol. 46(4), pages 875-906.
    25. Omar Azfar & Tugrul Gurgur, 2008. "Does corruption affect health outcomes in the Philippines?," Economics of Governance, Springer, vol. 9(3), pages 197-244, July.
    26. Lewis, Jeffrey B. & Linzer, Drew A., 2005. "Estimating Regression Models in Which the Dependent Variable Is Based on Estimates," Political Analysis, Cambridge University Press, vol. 13(4), pages 345-364.
    27. Hendrik Jürges, 2007. "True health vs response styles: exploring cross‐country differences in self‐reported health," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 163-178, February.
    28. Leiter, Michael P. & Harvie, Phyllis & Frizzell, Cindy, 1998. "The correspondence of patient satisfaction and nurse burnout," Social Science & Medicine, Elsevier, vol. 47(10), pages 1611-1617, November.
    29. Valentine, Nicole & Darby, Charles & Bonsel, Gouke J., 2008. "Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of "health systems responsiveness" in 41 countries," Social Science & Medicine, Elsevier, vol. 66(9), pages 1939-1950, May.
    30. Nigel Rice & Andrew Jones, 1997. "Multilevel models and health economics," Health Economics, John Wiley & Sons, Ltd., vol. 6(6), pages 561-575, November.
    31. Crossley, Thomas F. & Kennedy, Steven, 2002. "The reliability of self-assessed health status," Journal of Health Economics, Elsevier, vol. 21(4), pages 643-658, July.
    32. Miika Linna & Unto Häkkinen, 2006. "Reimbursing for the costs of teaching and research in finnish hospitals: A stochastic frontier analysis," International Journal of Health Economics and Management, Springer, vol. 6(1), pages 83-97, March.
    33. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-838, May.
    34. George France & Francesco Taroni & Andrea Donatini, 2005. "The Italian health‐care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 187-202, September.
    35. Hekkert, Karin Dorieke & Cihangir, Sezgin & Kleefstra, Sophia Martine & van den Berg, Bernard & Kool, Rudolf Bertijn, 2009. "Patient satisfaction revisited: A multilevel approach," Social Science & Medicine, Elsevier, vol. 69(1), pages 68-75, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Ángel Fernández-Pérez & Ángeles Sánchez, 2019. "Improving People’s Self-Reported Experience with the Health Services: The Role of Non-Clinical Factors," IJERPH, MDPI, vol. 17(1), pages 1-12, December.
    2. García-Corchero, Juan David & Jiménez-Rubio, Dolores, 2022. "How do policy levers shape the quality of a national health system?," Journal of Policy Modeling, Elsevier, vol. 44(1), pages 203-221.
    3. Dolores Jiménez‐Rubio & Judit Vall Castelló, 2020. "Limiting health‐care access to undocumented immigrants: A wise option?," Health Economics, John Wiley & Sons, Ltd., vol. 29(8), pages 878-890, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Fiorentini, Gianluca & Ragazzi, Giovanni & Robone, Silvana, 2015. "Are bad health and pain making us grumpy? An empirical evaluation of reporting heterogeneity in rating health system responsiveness," Social Science & Medicine, Elsevier, vol. 144(C), pages 48-58.
    2. William H. Greene & Mark N. Harris & Rachel J. Knott & Nigel Rice, 2021. "Specification and testing of hierarchical ordered response models with anchoring vignettes," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 184(1), pages 31-64, January.
    3. Andrew M. Jones; Nigel Rice, Silvana Robone; & Nigel Rice; & Silvana Robone:, 2012. "A comparison of parametric and non-parametric adjustments using vignettes for self-reported data," Health, Econometrics and Data Group (HEDG) Working Papers 12/10, HEDG, c/o Department of Economics, University of York.
    4. Raskina, Yulia & Podkorytova, Olga & Kuchakov, Ruslan, 2022. "Health determinants and the reporting heterogeneity bias in Russia: Anchoring vignettes approach," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 66, pages 118-143.
    5. Bertoni, Marco, 2015. "Hungry today, unhappy tomorrow? Childhood hunger and subjective wellbeing later in life," Journal of Health Economics, Elsevier, vol. 40(C), pages 40-53.
    6. Nigel Rice & Silvana Robone & Peter Smith, 2011. "Analysis of the validity of the vignette approach to correct for heterogeneity in reporting health system responsiveness," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 141-162, April.
    7. Gizem Arikan & Pazit Ben-Nun Bloom, 2019. "“I was hungry and you gave me food”: Religiosity and attitudes toward redistribution," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-24, March.
    8. William H. Greene & Mark N. Harris & Bruce Hollingsworth, 2015. "Inflated Responses in Measures of Self-Assessed Health," American Journal of Health Economics, MIT Press, vol. 1(4), pages 461-493, Fall.
    9. Teresa Bago d'Uva & Eddy Van Doorslaer & Maarten Lindeboom & Owen O'Donnell, 2008. "Does reporting heterogeneity bias the measurement of health disparities?," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 351-375, March.
    10. Valentine, Nicole & Verdes-Tennant, Emese & Bonsel, Gouke, 2015. "Health systems' responsiveness and reporting behaviour: Multilevel analysis of the influence of individual-level factors in 64 countries," Social Science & Medicine, Elsevier, vol. 138(C), pages 152-160.
    11. Rachel J. Knott & Nicole Black & Bruce Hollingsworth & Paula K. Lorgelly, 2017. "Response‐Scale Heterogeneity in the EQ‐5D," Health Economics, John Wiley & Sons, Ltd., vol. 26(3), pages 387-394, March.
    12. De Luca, Giacomo & Lisi, Domenico & Martorana, Marco & Siciliani, Luigi, 2021. "Does higher Institutional Quality improve the Appropriateness of Healthcare Provision?," Journal of Public Economics, Elsevier, vol. 194(C).
    13. Nils Gutacker & Chris Bojke & Silvio Daidone & Nancy J. Devlin & David Parkin & Andrew Street, 2013. "Truly Inefficient Or Providing Better Quality Of Care? Analysing The Relationship Between Risk‐Adjusted Hospital Costs And Patients' Health Outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 22(8), pages 931-947, August.
    14. Carmelo León & Jorge Araña & Javier León, 2013. "Correcting for Scale Perception Bias in Measuring Corruption: an Application to Chile and Spain," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 114(3), pages 977-995, December.
    15. Laura Rossouw & Teresa Bago d’Uva & Eddy Doorslaer, 2018. "Poor Health Reporting? Using Anchoring Vignettes to Uncover Health Disparities by Wealth and Race," Demography, Springer;Population Association of America (PAA), vol. 55(5), pages 1935-1956, October.
    16. Nicolas Sirven & Brigitte Santos-Eggimann & Jacques Spagnoli, 2012. "Comparability of Health Care Responsiveness in Europe," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 105(2), pages 255-271, January.
    17. Neil J. Buckley & Frank T. Denton & A. Leslie Robb & Byron G. Spencer, 2006. "Socio-economic Influences on the Health of Older Canadians: Estimates Based on Two Longitudinal Surveys," Canadian Public Policy, University of Toronto Press, vol. 32(1), pages 59-84, March.
    18. Bache, Stefan Holst Milton & Kristensen, Troels, 2013. "A simple but efficient approach to the analysis of multilevel data," DaCHE discussion papers 2013:6, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    19. Greene, William & Harris, Mark N. & Knott, Rachel & Rice, Nigel, 2023. "Reporting heterogeneity in modeling self-assessed survey outcomes," Economic Modelling, Elsevier, vol. 124(C).
    20. Aleksey Oshchepkov & Anna Shirokanova, 2020. "Multilevel Modeling For Economists: Why, When And How," HSE Working papers WP BRP 233/EC/2020, National Research University Higher School of Economics.

    More about this item

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I19 - Health, Education, and Welfare - - Health - - - Other
    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities
    • C50 - Mathematical and Quantitative Methods - - Econometric Modeling - - - General

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:27:y:2018:i:2:p:266-281. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.