Association between market concentration of hospitals and patient health gain following hip replacement surgery.
Association between market concentration of hospitals and patient health gain following hip replacement surgery.
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DOI：
10.1177/1355819614546032
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发表时间：
2015-01
影响因子：
2.4
通讯作者：
Sussex J
中科院分区：
文献类型：
--
作者：
Feng Y;Pistollato M;Charlesworth A;Devlin N;Propper C;Sussex J
评估医院的市场集中度（作为竞争的代理）与选择性原发性髋关节置换术后患者报告的健康收益之间的关系。患者报告的结果测量数据与2011/12年英国NHS医院事件统计数据相关，用于分析由赫芬达尔-赫希曼指数（HHI）衡量的医院市场集中度与337家医院的健康收益之间的关系。市场集中度与初次髋关节置换术后牛津髋关节评分（OHS）变化测量的患者健康状况增加之间的关联在5%的水平上无统计学意义，无论是对普通患者还是对髋关节疾病严重程度高于平均水平的患者（OHS高于平均水平）。在12583例（49.1%）髋关节置换术前OHS优于平均水平的患者中，HHI每增加一个标准差，相当于当地市场上大约一家医院的减少，与患者术后自我报告的OHS改善减少0.104相关，但在5%的水平下，这没有统计学意义。医院市场集中度（作为竞争的代表）似乎对选择性原发性髋关节置换术的结果没有显著影响（在5%的水平上）。这一发现的普遍性需要进一步研究。
To assess the association between market concentration of hospitals (as a proxy for competition) and patient-reported health gains after elective primary hip replacement surgery. Patient Reported Outcome Measures data linked to NHS Hospital Episode Statistics in England in 2011/12 were used to analyse the association between market concentration of hospitals measured by the Herfindahl-Hirschman Index (HHI) and health gains for 337 hospitals. The association between market concentration and patient gain in health status measured by the change in Oxford Hip Score (OHS) after primary hip replacement surgery was not statistically significant at the 5% level both for the average patient and for those with more than average severity of hip disease (OHS worse than average). For 12,583 (49.1%) patients with an OHS before hip replacement surgery better than the mean, a one standard deviation increase in the HHI, equivalent to a reduction of about one hospital in the local market, was associated with a 0.104 decrease in patients’ self-reported improvement in OHS after surgery, but this was not statistically significant at the 5% level. Hospital market concentration (as a proxy for competition) appears to have no significant influence (at the 5% level) on the outcome of elective primary hip replacement. The generalizability of this finding needs to be investigated.
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DOI：
10.1111/j.1468-0297.2011.02449.x
发表时间：
2011-08
期刊：
Economic journal (London, England)
影响因子：
--
作者：
Cooper Z;Gibbons S;Jones S;McGuire A
通讯作者：
McGuire A
影响因子：
5.3
作者：
Gaynor, Martin;Moreno-Serra, Rodrigo;Propper, Carol
通讯作者：
Propper, Carol
影响因子：
2.1
作者：
Clarke, Kevin A.
通讯作者：
Clarke, Kevin A.
影响因子：
2.1
作者：
Clarke, KA
通讯作者：
Clarke, KA
影响因子：
3.5
作者：
Feng, Yan;Parkin, David;Devlin, Nancy J.
通讯作者：
Devlin, Nancy J.