Quality of Care in Australian Public and Private Hospitals 澳大利亚公立和私立医院的护理质量.docVIP

Quality of care in Australian public and private hospitals Matthew Forbes, Philip Harslett, Ilias Mastoris and Leonora Risse Productivity Commission Presented at Australian Conference of Health Economists Sydney September 30 – October 1, 2010 Abstract This analysis examines the quality of in Australian public and private hospitals, where quality is measured using an in-hospital standardised mortality ratio. Using hospital-level data, the determinants of in-hospital mortality across both Australian public and private hospitals are estimated with a negative binomial regression using hospital-level pooled nation-wide ABS and AIHW establishment and patient data from 2003-04 to 2006-07. The largest (and most comparable) public and private hospitals were found to have similar adjusted mortality ratios. Smaller public hospitals were generally found to have greater than expected levels of mortality. To estimate the interaction between the quality of care and the technical efficiency of public and private hospitals, the estimated hospital-standardised mortality ratios were then included as regressors in the stochastic distance function to estimate hospital technical efficiency. A description of that analysis is contained in a companion paper Measuring the technical efficiency of public and private hospitals in Australia. Overall, Australian acute hospitals were estimated to have scope to improve their efficiency by about 10?per?cent in the existing policy environment. 1 Introduction Interest in the efficiency of Australian hospitals is becoming more and more important due to the escalating demands placed on our health system by an ageing population, heightened community expectations regarding health care, and increasing costs of new medical technologies. By improving efficiency within hospitals, there is an opportunity to free up resources for use elsewhere, either within hospitals or the broader health care sector, in order to improve the community’s wellbeing. The import