Impact of health spending on hospitalization rates in Baltic countries: a comparative analysis.
Baltic Countries
GAM model
Health Spending
Healthcare systems
Hospitalization
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
10 Jun 2024
10 Jun 2024
Historique:
received:
28
02
2023
accepted:
19
05
2024
medline:
11
6
2024
pubmed:
11
6
2024
entrez:
10
6
2024
Statut:
epublish
Résumé
This study examines the association between healthcare indicators and hospitalization rates in three high-income European countries, namely Estonia, Latvia, and Lithuania, from 2015 to 2020. We used a sex-stratified generalized additive model (GAM) to investigate the impact of select healthcare indicators on hospitalization rates, adjusted by general economic status-i.e., gross domestic product (GDP) per capita. Our findings indicate a consistent decline in hospitalization rates over time for all three countries. The proportion of health expenditure spent on hospitals, the number of physicians and nurses, and hospital beds were not statistically significantly associated with hospitalization rates. However, changes in the number of employed medical doctors per 10,000 population were statistically significantly associated with changes of hospitalization rates in the same direction, with the effect being stronger for males. Additionally, higher GDP per capita was associated with increased hospitalization rates for both males and females in all three countries and in all models. The relationship between healthcare spending and declining hospitalization rates was not statistically significant, suggesting that the healthcare systems may be shifting towards primary care, outpatient care, and on prevention efforts.
Identifiants
pubmed: 38858705
doi: 10.1186/s12913-024-11119-4
pii: 10.1186/s12913-024-11119-4
doi:
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
714Subventions
Organisme : NIAAA NIH HHS
ID : 1R01AA028224
Pays : United States
Organisme : NIAAA NIH HHS
ID : 1R01AA028224
Pays : United States
Organisme : NIAAA NIH HHS
ID : 1R01AA028224
Pays : United States
Organisme : NIAAA NIH HHS
ID : 1R01AA028224
Pays : United States
Informations de copyright
© 2024. The Author(s).
Références
van Ginneken E, Habicht J, Murauskiene L, Behmane D, Mladovsky P. The baltic states: building on 20 years of health reforms. BMJ. 2012;345. doi:.
healthcare-in-europe.com. The Baltic States and their health systems - From Soviet to EU: The Estonian health system differs from its Baltic neighbour states thanks to a transformation process and reforms [Internet]. Munich, Germany: mg fach verlage. 2006. https://healthcare-in-europe.com/en/news/the-baltic-states-their-health-systems-from-soviet-to-eu.html Accessed: 2023 Feb 2.
Berger E, Winkelmann J, Eckhardt H, Nimptsch U, Panteli D, Reichebner C, et al. A country-level analysis comparing hospital capacity and utilisation during the first COVID-19 wave across Europe. Health Policy. 2022;126(5):373–81.
doi: 10.1016/j.healthpol.2021.11.009
pubmed: 34924210
eurostat statistics explained. Healthcare expenditure statistics [Internet]. 2023. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Healthcare_expenditure_statistics#:~:text=Hospitals%20accounted%20for%20the%20highest,Germany%20to%2048.0%20%25%20in%20Romania . Accessed: 31/12/2023.
Håkansson A, Ovhed I, Jurgutis A, Kalda R, Ticmane G. Family medicine in the baltic countries. Scand J Prim Health Care. 2008;26(2):67–9.
doi: 10.1080/02813430802030090
pubmed: 18570002
pmcid: 3406650
Shain M, Roemer MI. Hospital costs relate to the supply of beds. Mod Hosp. 1959;92(4):71 – 3 passim. doi.
Delamater PL, Messina JP, Grady SC, WinklerPrins V, Shortridge AM. Do more hospital beds lead to higher hospitalization rates? A spatial examination of Roemer’s Law. PLoS ONE. 2013;8(2):e54900. https://doi.org/10.1371/journal.pone.0054900 .
doi: 10.1371/journal.pone.0054900
pubmed: 23418432
pmcid: 3572098
Alexander JA, Lee SY, Griffith JR, Mick SS, Lin X, Banaszak-Holl J. Do market-level hospital and physician resources affect small area variation in hospital use? Med Care Res Rev. 1999;56(1):94–117. https://doi.org/10.1177/107755879905600106 .
doi: 10.1177/107755879905600106
pubmed: 10189779
van Doorslaer EK, van Vliet RC. A built bed is a filled bed? An empirical re-examination. Soc Sci Med. 1989;28(2):155–64. https://doi.org/10.1016/0277-9536(89)90143-3 .
doi: 10.1016/0277-9536(89)90143-3
pubmed: 2928825
Clark JD. Variation in Michigan hospital use rates: do physician and hospital characteristics provide the explanation? Soc Sci Med. 1990;30(1):67–82. https://doi.org/10.1016/0277-9536(90)90330-u .
doi: 10.1016/0277-9536(90)90330-u
pubmed: 2305285
Torrini I, Lucifora C, Russo AG. The long-term effects of hospitalization on health care expenditures: an empirical analysis for the young-old population in Lombardy. Health Policy. 2023;132:104803. https://doi.org/10.1016/j.healthpol.2023.104803 .
doi: 10.1016/j.healthpol.2023.104803
pubmed: 37030272
Raghupathi V, Raghupathi W. Healthcare expenditure and economic performance: insights from the United States Data. Front Public Health. 2020;8:156. https://doi.org/10.3389/fpubh.2020.00156 .
doi: 10.3389/fpubh.2020.00156
pubmed: 32478027
pmcid: 7237575
Kalseth J, Halvorsen T. Health and care service utilisation and cost over the life-span: a descriptive analysis of population data. BMC Health Serv Res. 2020;20(1):435. https://doi.org/10.1186/s12913-020-05295-2 .
doi: 10.1186/s12913-020-05295-2
pubmed: 32429985
pmcid: 7236310
Yu CW, Alavinia SM, Alter DA. Impact of socioeconomic status on end-of-life costs: a systematic review and meta-analysis. BMC Palliat Care. 2020;19(1):35. https://doi.org/10.1186/s12904-020-0538-y .
doi: 10.1186/s12904-020-0538-y
pubmed: 32293403
pmcid: 7087362
OECD iLibrary. Health for Everyone? Social Inequalities in Health and Health Systems [Internet]. Paris, France: OECD. 2019. https://www.oecd-ilibrary.org/sites/3c8385d0-en/index.html?itemId=/content/publication/3c8385d0-en . Accessed: 2023 Feb 2.
Burns R, Graversen P, Miller A, Bader C, Offe J, Fille F, et al. Left behind: the state of universal health coverage in Europe. Eur J Pub Health. 2020;30(Supplement5):ckaa165.
Commission E, Justice D-G, Franklin C, Bambra P, Albani C. V. Gender equality and health in the EU: Publications Office; 2021.
Roxo L, Bambra C, Perelman J. Gender Equality and Gender Inequalities in self-reported health: a longitudinal study of 27 European countries 2004 to 2016. Int J Health Serv. 2021;51(2):146–54.
doi: 10.1177/0020731420960344
pubmed: 33019863
Barke A, Korwisi B, Jakob R, Konstanjsek N, Rief W, Treede R-D. Classification of chronic pain for the International classification of diseases (ICD-11): results of the 2017 international World Health Organization field testing. Pain. 2022;163(2):e310.
doi: 10.1097/j.pain.0000000000002287
pubmed: 33863861
ANDMEBAAS Health Statistics and Health Research Database. Database. [Internet]. Tallinn, Estonia: National Institute for Health Development. 2023. https://statistika.tai.ee/pxweb/en/Andmebaas/Andmebaas__02Haigestumus . Accessed: 2023 Feb 2.
Institute of Hygiene (Higienos Institutas). Home page [Internet]. Vilnius, Lithuania: Higienos Institutas. 2020. https://www.hi.lt/en/ . Accessed: 14/02/2023.
National Service Republic of Latvia. About Us [Internet]. Rīga, Latvia: Nacionālais veselības dienests. 2023. https://www.vmnvd.gov.lv/en/about-us . Accessed: 2023 Feb 2.
Global Health Data Exchange (GHDx). Global Health Data Exchange [Internet], Seattle. Washington: Institute for Health Metrics and Evaluation (IHME); 2022. http://ghdx.healthdata.org . Accessed: 2023 Feb 2.
eurostat statistics explained. Preventive health care expenditure statistics [Internet]. 2023. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Preventive_health_care_expenditure_statistics . Accessed: 31/12/2023.
OECD Stat. Gross domestic product (GDP): GDP per capita, USD, current prices and PPPs [Internet]. 2023. https://stats.oecd.org/index.aspx?queryid=61433# . Accessed: 31/12/2023.
The World Bank. Life expectancy at birth, total (years) - Central Europe and the Baltics [Internet], Washington DC. The World Bank Group; 2023. https://data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=B8 . Accessed: 14/02/2023.
Kaplan RM, Spittel ML, David DH. Population health: behavioral and social science insights. Government Printing Office; 2015.
Blas E, Sivasankara Kurup A. Equity, social determinants and public health programmes. Geneva: World Health Organization; 2010 2010. Report No.: 9789241563970.
Beard E, Marsden J, Brown J, Tombor I, Stapleton J, Michie S, et al. Understanding and using time series analyses in addiction research. Addiction. 2019;114(10):1866–84.
doi: 10.1111/add.14643
pubmed: 31058392
Harrell FE Jr. Regression Modeling Strategies With Applications To Linear Models, Logistic And Ordinal Regression, And Survival Analysis. pdf. 2015. doi.
R Core Team. A language and environment for statistical computing [Internet]. Vienna, Austria: R Foundation for Statistical Computing. 2018. https://www.R-project.org/ . Accessed: 2023 Feb 2.
Behmane D, Dudele A, Villerusa A, Misins J, Klavina K, Mozgis D, et al. Latvia: Health Syst Rev Health Syst Transit. 2019;21(4):1–165.
European Observatory on Health Systems and Policies. Estonia: health system review 2023 [Internet]. 2023. https://eurohealthobservatory.who.int/publications/i/estonia-health-system-review-2023 . Accessed: 31/12/2023.
OECD iLibrary. Chapter 3. Health care system in Lithuania: Efficiency and quality [Internet]. Paris, France: OECD. 2018. https://www.oecd-ilibrary.org/sites/9789264300873-7-en/index.html?itemId=/content/component/9789264300873-7-en . Accessed: 31/12/2023.
eurostat statistics explained. Hospital discharges, in-patients. 2013 and 2018 (per 100 000 inhabitants) Health20 [Internet]. Brussels: European Commission; 2020. https://ec.europa.eu/eurostat/statistics-explained/index.php?title=File:Hospital_discharges,_in-patients,_2013_and_2018_(per_100_000_inhabitants)_Health20.png . Accessed: 2023 Feb 2.
Aiyar S, Ebeke CH, The Impact of Workforce Aging on European Productivity. IMF Working Papers [Internet]. 2016 Accessed: 22/03/2024; 2016(238):A001. https://www.elibrary.imf.org/view/journals/001/2016/238/article-A001-en.xml .
Netspar Panel Papers. Panel paper 35: The influence of health care spending on life expectancy [Internet]. Tilburg, Netherlands: Netspar. 2013. https://repub.eur.nl/pub/40722/Metis_190158.pdf . Accessed: 31/12/2023.
Varpina Z. Countries of old men? Demographic challenges in Estonia, Latvia and Lithuania [Internet]. Riga, Latvia:, Friedrich-Ebert. -Stiftung (FES); 2018. https://baltic.fes.de/fileadmin/user_upload/documents/FES_Countries_of_old_men_final.pdf Accessed: 2023 Feb 2.
Portela MCC, Fernandes AC. Gender and healthcare accessibility in Europe. J Hosp Adm. 2014;3(6):163–73.
Institute for Health Metrics and Evaluation (IHME). Global Burden of Disease (GBD) [Internet]. Seattle, Washington: IHME. 2023. https://www.healthdata.org/about/contact-us . Accessed: 2023 Feb 2.