The effect of health care expenditure on patient outcomes: Evidence from English neonatal care

Health Economics
Samuel WatsonNESCOP

Abstract

The relationship between health care expenditure and health outcomes has been the subject of recent academic inquiry in order to inform cost-effectiveness thresholds for health technology assessment agencies. Previous studies in public health systems have relied upon data aggregated at the national or regional level; however, there remains debate about whether the supply side effect of changes to expenditure are identifiable using data at this level of aggregation. We use detailed patient data derived from electronic neonatal records across England along with routinely available cost data to estimate the effect of changes to patient expenditure on clinical health outcomes in a well-defined patient population. A panel of 32 neonatal intensive care units for the period 2009-2013 was constructed. Accounting for the potential endogeneity of expenditure a £100 increase in the cost per intensive care cot day (sample average cost: £1,127) is estimated to reduce the risk of mortality of 0.38 percentage points (sample average mortality: 11.0%) in neonatal intensive care. This translates into a cost per life saved in neonatal intensive care of approximately £420,000.

References

Jun 10, 2000·Journal of Health Economics·G Gowrisankaran, R J Town
Mar 17, 2005·JAMA : the Journal of the American Medical Association·Therese A StukelDavid E Wennberg
Dec 3, 2005·Pediatrics·Richard A EhrenkranzUNKNOWN National Institutes of Child Health and Human Development Neonatal Research Network
May 13, 2006·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Bryan R LuceL Clark Paramore
Sep 1, 2006·The New England Journal of Medicine·David M CutlerSandeep Vijan
Feb 12, 2008·Journal of Health Economics·Stephen MartinPeter C Smith
Jul 17, 2010·The Quarterly Journal of Economics·Douglas AlmondHeidi Williams
Apr 12, 2012·BMJ : British Medical Journal·C GaleUNKNOWN Neonatal Data Analysis Unit and the Medicines for Neonates Investigator Group
Feb 19, 2015·Health Technology Assessment : HTA·Karl ClaxtonMark Sculpher
Feb 11, 2016·Archives of Disease in Childhood. Fetal and Neonatal Edition·S I WatsonUNKNOWN Neonatal Data Analysis Unit (NDAU) and the Neonatal Economic, Staffing, and Clinical Outcomes Project (NESCOP) Group
Aug 28, 2016·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Laura Vallejo-TorresPedro Serrano-Aguilar

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