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The Dutch experience in measuring health output and labour productivity

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.

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The Dutch experience in measuring health output and labour productivity

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  1. The Dutch experience in measuring health output and labour productivity Antonio Chessa Foske Kleima Statistics Netherlands (CBS)

  2. Outline Output index for hospitals Other health sectors (data) Labour productivity of general hospitals

  3. Health output hospitals Clinical and day treatments Outpatient services Other services: • Psychiatric treatments • Rehabilitation • Outpatient births • Haemodialysis • Thrombosis services

  4. Clinical and day treatments: Data • Hospital Discharge Register (Dutch LMR) For every patient: • Date of birth • Diagnosis (ICD-codes) • Hospitalisation days • Clinical (≥ 24 hrs) or day treatment (< 24 hrs)

  5. Clinical and day treatments: Index • Diagnosis Age-groups: • Diagnosis: 3-digit ICD • Age: 7 classes Volume indices: • Discharges per DA-group are counted • Clinical and day treatments are added • Index per DA-group: Dischargesyr t / Dischargesyr t – 1 Weights for DA-indices: • Hospitalisation days • Annually adjusted

  6. Index for other services • Outpatient: Visits yr t / visits yr t – 1 Similar index for remaining services: • Treatments yr t / treatments yr t – 1 • Blood takings yr t / blood takings yr t – 1 • Births yr t / births yr t – 1

  7. Overall Laspeyres index • Clinical and day (D): • Other services (R): • Overall index: Cost weights

  8. Output general hospitals

  9. Other health sectors NA use a C-method for: • 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?

  10. Production data • Example: Nursing homes • Main output: Nursing days Product composition changes over time: • New products added (home care, assistance) • Changes of same product

  11. How to make an index? • Nursing days can be tracked yearly How to incorporate new products? New products!

  12. Labour productivity • Sector: General hospitals • LP = Output / Labour input • Labour input: • Measured in fte’s • Correction for sick and maternity leave • Differentiation by profession group • Group weights based on salaries

  13. Labour productivity: Results

  14. Comparison with other sectors

  15. Future plans • Health output: • Development of output index for other sectors • How to deal with new products? • Integration with method for hospitals • Labour productivity: • Also for other health sectors • Effect of uncertainties

  16. Questions? Domande? Preguntas? Vragen? Spørsmåler? Fragen? Questions? ¿Preguntas?

  17. For more info… • Antonio Chessa • Statistics Netherlands (CBS) • Tel.: +31 (0)70 337 4577 • E-mail: acsa@cbs.nl • http://www.cbs.nl

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