000075512 001__ 75512
000075512 005__ 20200117221641.0
000075512 0247_ $$2doi$$a10.1186/s12913-018-3445-7
000075512 0248_ $$2sideral$$a107990
000075512 037__ $$aART-2018-107990
000075512 041__ $$aeng
000075512 100__ $$aRidao-Lopez, M.
000075512 245__ $$aEvolution of public hospitals expenditure by healthcare area in the Spanish National Health System: the determinants to pay attention to
000075512 260__ $$c2018
000075512 5060_ $$aAccess copy available to the general public$$fUnrestricted
000075512 5203_ $$aBackground: In Spain, hospital expenditure represents the biggest share of overall public healthcare expenditure, the most important welfare system directly run by the Autonomous Communities (ACs). Since 2001, public healthcare expenditure has increased well above the GDP growth, and public hospital expenditure increased at an even faster rate. This paper aims at assessing the evolution of need-adjusted public hospital expenditure at healthcare area level (HCA) and its association with utilisation and ''price'' factors, identifying the relative contribution of ACs, as the main locus of health policy decisions. Methods: Ecological study on public hospital expenditure incurred in 198 (HCAs) in 16 Spanish ACs, between 2003 and 2015. Aggregated and annual log-log multilevel models, considering ACs as a cluster, were modelled using administrative data. HCA expenditure was analysed according to differences in population need, utilization and price factors. Standardised coefficients were also estimated, as well as the variance partition coefficients. Results: Between 2003 and 2015, over 59 million hospital episodes were produced in Spain for an overall expenditure of (sic) 384, 200 million. Need-adjusted public hospital expenditure, at HCA level, was mainly associated to medical and surgical hospitalizations (standardized coefficients 0.32 and 0.28, respectively). The ACs explained 42% of the variance not explained by HCA utilization and ''price'' factors. Conclusions: Utilization, rather than ''price'' factors, may be explaining the difference in need-adjusted public hospital expenditure at HCA level in Spain. ACs, third-payers in the fully devolved Spanish National Health System, are responsible for a great deal of the variation in hospital expenditure.
000075512 536__ $$9info:eu-repo/grantAgreement/ES/MINEIC/ECO2017-83771-C3-2-R$$9info:eu-repo/grantAgreement/ES/REDISSEC/RD16-0001-0007
000075512 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000075512 590__ $$a1.932$$b2018
000075512 591__ $$aHEALTH CARE SCIENCES & SERVICES$$b52 / 96 = 0.542$$c2018$$dQ3$$eT2
000075512 592__ $$a1.057$$b2018
000075512 593__ $$aHealth Policy$$c2018$$dQ1
000075512 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000075512 700__ $$aComendeiro-Maaloe, M.
000075512 700__ $$aMartinez-Lizaga, N.
000075512 700__ $$0(orcid)0000-0002-0961-3298$$aBernal-Delgado, E.
000075512 773__ $$g18 (2018), 696 [9 pp]$$pBMC HEALTH SERV RES$$tBMC HEALTH SERVICES RESEARCH$$x1472-6963
000075512 8564_ $$s1039878$$uhttps://zaguan.unizar.es/record/75512/files/texto_completo.pdf$$yVersión publicada
000075512 8564_ $$s80526$$uhttps://zaguan.unizar.es/record/75512/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000075512 909CO $$ooai:zaguan.unizar.es:75512$$particulos$$pdriver
000075512 951__ $$a2020-01-17-22:04:26
000075512 980__ $$aARTICLE