| Title |
Trends and regional variation in rates of orthopaedic surgery in Germany: the impact of competition
|
|---|---|
| Published in |
HEPAC Health Economics in Prevention and Care, July 2018
|
| DOI | 10.1007/s10198-018-0990-2 |
| Pubmed ID | |
| Authors |
Natalie Baier, Lisa-Marie Sax, Leonie Sundmacher |
| Abstract |
Competition in hospital services has been fostered in an increasing number of OECD countries with the goal that hospitals improve quality and/or efficiency. With the same intention competition has been promoted in Germany when introducing a system of prospective payments based on diagnosis-related groups (DRGs) in 2003. Beyond its intended effects, however, the reform led to a substantial increase in hospital activity, particularly for orthopaedic surgery. To shed more light on these developments, this paper analyses the relationship between the rates of certain orthopaedic surgical procedures and hospital competition across and within each of Germany's 402 districts. We measured competition with the Herfindahl-Hirschman Index (HHI) based on market shares for hip replacements, knee replacements and spine surgeries. Using spatial panel regression, which allows for spatial dependency and unobserved individual heterogeneity, we found that the rate of hip and knee replacements rose as market concentration increased. A potential explanation might be that hospitals specialize in these particular procedures. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 37 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 7 | 19% |
| Student > Master | 5 | 14% |
| Other | 2 | 5% |
| Student > Doctoral Student | 1 | 3% |
| Student > Bachelor | 1 | 3% |
| Other | 4 | 11% |
| Unknown | 17 | 46% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 16% |
| Economics, Econometrics and Finance | 5 | 14% |
| Business, Management and Accounting | 2 | 5% |
| Nursing and Health Professions | 2 | 5% |
| Earth and Planetary Sciences | 1 | 3% |
| Other | 3 | 8% |
| Unknown | 18 | 49% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 July 2018.
All research outputs
#20,663,600
of 25,385,509 outputs
Outputs from HEPAC Health Economics in Prevention and Care
#1,039
of 1,303 outputs
Outputs of similar age
#266,102
of 341,564 outputs
Outputs of similar age from HEPAC Health Economics in Prevention and Care
#13
of 15 outputs
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