Management schemes in the public Catalan hospital system

Ortún Rubio, Vicente; Serra Burriel, Miquel; Manganelli, Anton-Giulio

Management schemes in the public Catalan hospital system

Citation

Ortún Rubio, V, Serra Burriel, M, Manganelli, A. Management schemes in the public Catalan hospital system. 2017. handle: http://hdl.handle.net/10230/47671

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Abstract

Background: The Results Centre (CdR) of the Integrated Public Use Healthcare System of Catalonia (SISCAT) is a comprehensive network of public information about healthcare utilization and results at all levels. The aim of the present study is to explore the CdR associations between different domains of activity and health outcomes and the different management schemes present in the public system. Methods: We performed several linear regression models with panel data from all SISCAT hospitals N=66 for the period 2012-2015 on general indicators of adequacy, safety, effectiveness, efficiency and economic outcomes over management system. We control for geographic fixed-effects, time trends, activity and patient complexity to overcome unobservables. Results: We find several statistically significant associations between activity, health outcomes and management scheme. We only find differences between Direct Public Management (ICS1) and Consortiums and Public Companies (ICS2) in readmission rates for diabetes episodes. Other Public companies (ICS3) are only associated with lower readmission rates for chronic obstructive pulmonary disease readmission rates. Private-for-Profit hospitals are associated with poorer adequacy measured as cesarean section rate, and longer length of stay for femoral neck fracture and acute myocardial infraction than other management forms. There are structural associations for some of the selected indicators that are potentially explained by the network structure. Discussion : This study provides suggestive evidence on the potential associations between management schemes and hospital activity and outcomes indicators in the SISCAT public healthcare provision system for the 2012-2015 period, these results were not sensible to the robustness checks performed.