Analyzing the 20-year declining trend of hospital length-of-stay in European countries with different healthcare systems and reimbursement models

AbstractThe study aims to investigate the last 20-year (2000 –2019) of hospital length of stay (LOS) trends and their association with different healthcare systems (HS) among 25 European countries. A panel dataset was created using secondary data from Eurostat and Global Burden of Disease study databases, with dependent and control variables aggregated at t he national level over a period of 20 years. A time trend analysis was conducted using a weighted least squares model for panel data to investigate the association between LOS, HS models [National Health Service (NHS), National Health Insurance, Social Health Insurance (SHI), and Etatist Social Hea lth Insurance], healthcare reimbursement schemes [Prospective Global Budget (PGB), Diagnosis Related Groups (DRG), and Procedure Service Payment (PSP)], and control variables. The study showed a reduction of average LOS from 9.20 days in 2000 to 7.24 in 2019. SHI was associated with a lower LOS com pared to NHS (b = − 0.6327,p <  0.05). Both DRG (b = 1.2399,p <  0.05) and PSP (b = 1.1677,p <  0.05) reimbursement models were positively associated with LOS compared to PGB. Our results confirmed the downward trend of LOS in the last 20 years, its multifactorial nature, and the influence of the SHI model of HS. This could be due to the financial incentives present in fee-for-service paym ent models and the role of competition in creating a market for healthcare services. These results offer ...
Source: International Journal of Health Care Finance and Economics - Category: Health Management Source Type: research