The volume-outcome relationship and minimum volume standards--empirical evidence for Germany.
For decades, there is an ongoing discussion about the quality of hospital care leading i.a. to the introduction of minimum volume standards in various countries. In this paper, we analyze the volume-outcome relationship for patients with intact abdominal aortic aneurysm and hip fracture. We define hypothetical minimum volume standards in both conditions and assess consequences for access to hospital services in Germany. The results show clearly that patients treated in hospitals with a higher case volume have on average a significant lower probability of death in both conditions. Furthermore, we show that the hypothetical minimum volume standards do not compromise overall access measured with changes in travel times.
Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Essen, Germany; Ruhr-University Bochum, Germany.
Corinna
C
Hentschker
Roman
R
Mennicken
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000628:therapy*; D015897:Comorbidity; D005260:Female; D005858:Germany; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000401:mortality / Q000628:therapy*; D006742:Hospital Bed Capacity; D017052:Hospital Mortality; D061846:Hospitals, Low-Volume / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017059:Models, Econometric; D010067:Ownership; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D014195:Travel
Germany; hospital quality; minimum volume standards; mortality; volume-outcome