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Inefficiencies in a healthcare system with a regulatory split of power: a spatial panel data analysis of avoidable hospitalisations in Austria

Despite generous universal social health insurance with little formal restrictions of outpatient utilisation, Austria exhibits high
rates of avoidable hospitalisations, which indicate the inefficient provision of primary healthcare and might be a consequence
of the strict regulatory split between the Austrian inpatient and outpatient sector. This paper exploits the considerable regional
variations in acute and chronic avoidable hospitalisations in Austria to investigate whether those inefficiencies in primary
care are rather related to regional healthcare supply or to population characteristics. To explicitly account for inter-regional
dependencies, spatial panel data methods are applied to a comprehensive administrative dataset of all hospitalisations from
2008 to 2013 in the 117 Austrian districts. The initial selection of relevant covariates is based on Bayesian model averaging.
The results of the analysis show that supply-side variables, such as the number of general practitioners, are significantly
associated with decreased chronic and acute avoidable hospitalisations, whereas characteristics of the regional population,
such as the share of population with university education or long-term unemployed, are less relevant. Furthermore, the spatial
error term indicates that there are significant spatial dependencies between unobserved characteristics, such as practice style
or patients' utilization behaviour. Not accounting for those would result in omitted variable bias.

Identiferoai:union.ndltd.org:VIENNA/oai:epub.wu-wien.ac.at:7207
Date09 1900
CreatorsRenner, Anna-Theresa
PublisherSpringer Berlin Heidelberg
Source SetsWirtschaftsuniversität Wien
LanguageEnglish
Detected LanguageEnglish
TypeArticle, PeerReviewed
Formatapplication/pdf
RightsCreative Commons: Attribution 4.0 International (CC BY 4.0)
Relationhttps://doi.org/10.1007/s10198-019-01113-7, http://epub.wu.ac.at/7207/

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