Transcript CBS: kennisinstituut of ken-niks-instituut

The Dutch experience in measuring
health output and labour productivity
Antonio Chessa
Foske Kleima
Statistics Netherlands (CBS)
Outline
Output index for hospitals
Other health sectors (data)
Labour productivity of general hospitals
Health output hospitals
Clinical and day treatments
Outpatient services
Other services:
o
o
o
o
o
Psychiatric treatments
Rehabilitation
Outpatient births
Haemodialysis
Thrombosis services
Clinical and day treatments: Data
Hospital Discharge Register (Dutch LMR)
For every patient:
o
o
o
o
Date of birth
Diagnosis (ICD-codes)
Hospitalisation days
Clinical (≥ 24 hrs) or day treatment (< 24 hrs)
Clinical and day treatments: Index
Diagnosis Age-groups:
o Diagnosis: 3-digit ICD
o Age: 7 classes
Volume indices:
o Discharges per DA-group are counted
o Clinical and day treatments are added
o Index per DA-group:
Discharges yr t / Discharges yr t – 1
Weights for DA-indices:
o Hospitalisation days
o Annually adjusted
Index for other services
Outpatient: Visits yr t / visits yr t – 1
Similar index for remaining services:
o Treatments yr t / treatments yr t – 1
o Blood takings yr t / blood takings yr t – 1
o Births yr t / births yr t – 1
Overall Laspeyres index
v
Clinical and day (D):
i ,t 1
iD
Ti ,t
Other services (R):
cD
v
i ,t 1
iD
Ti ,t 1
, for all i  R
Ti ,t 1
Overall index:
Ti ,t
Ti ,t
Ti ,t 1

Cost weights
Ti ,t
c T
i
iR
i ,t 1
Output general hospitals
125
Clinical and day tr.
Outpatient
120
Overall index
115
110
105
100
95
1997
1998
Sources: CBS, Prismant
1999
2000
2001
2002
2003
2004
Other health sectors
NA use a C-method for:
o
o
o
o
o
Nursing homes
Homes for elderly
Home health care
Psychiatric institutes
Institutes for disabled
Total budget covers 3.5% of Dutch GDP
Is a B-method possible?
Production data
Example: Nursing homes
Main output: Nursing days
Product composition changes over time:
o New products added (home care, assistance)
o Changes of same product
How to make an index?
Nursing days can be tracked yearly
How to incorporate new products?
Nursing homes
Year
Budget
Days
1998
100
100
80.9
1999
103.7
100.3
81.6
2000
107.9
102.2
82.9
2001
134.5
104.7
72.4
2002
148.8
107.7
71.5
2003
161.4
110.1
72.2
Source: CTG
% of budget
New products!
Labour productivity
Sector: General hospitals
LP = Output / Labour input
Labour input:
o
o
o
o
Measured in fte’s
Correction for sick and maternity leave
Differentiation by profession group
Group weights based on salaries
Labour productivity: Results
120
Overall output
Overall labour input
115
Labour productivity
110
105
100
95
1997
1998
Sources: CBS, Prismant
1999
2000
2001
2002
2003
2004
Comparison with other sectors
120
115
Dutch economy (VA)
Dutch market sector (VA)
General hospitals (gross)
110
105
100
95
1997
1998
Source: CBS StatLine
1999
2000
2001
2002
2003
2004
Future plans
Health output:
o Development of output index for other sectors
o How to deal with new products?
o Integration with method for hospitals
Labour productivity:
o Also for other health sectors
o Effect of uncertainties
Questions?
Domande?
Vragen?
Preguntas?
Spørsmåler?
Fragen?
Questions?
¿Preguntas?
For more info…
Antonio Chessa
Statistics Netherlands (CBS)
Tel.:
+31 (0)70 337 4577
E-mail: [email protected]
http://www.cbs.nl