Identificador: TDX:2876
Autors: Fonts Ribas, Albert
Resum:
The general objective of the thesis is to carry out a study of variability in the consumption of resources in Spanish hospitals, based on explanatory variables related to the supply and demand of health resources, identified from the review of published studies. For this, the hospital length of stay is taken for the set of treatments defined by the Diagnostic Related Groups, because it is directly related to the variation in cost and healthcare expenses.
Two analysis models are presented: 1) regression model with dummy explanatory variables, and 2) dynamic panel data model for the Spanish Autonomous Communities.
In model 1, it is showed a significant decrease in hospital length of stay and a higher variability of the surgical treatments, compared with medicals. The hospitals with higher number of beds and with a greater structural weight and level of activity offer higher values of length, in which the outliers of length have a greater effect.
In model 2, the supply variables, number of beds, number of doctors, complexity index and number of hemodynamic equipment show a direct relationship with the length of stay; and the hospital day units and ambulatory surgery, an inverse relationship. The number of ACT equipment does not show a significant relationship. The group of demand variables are shown to be significant and with a negative sign, the morbidity rate and the frequency of admissions, and with a positive sign the percentage of the older population. The school life expectancy, the average income and the poverty rate are not significant. There are differences between communities and the existence of individual fixed effects among them.
Repositori URV