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Do independent treatment centers offer more value than general hospitals? The case of cataract care.

ABSTRACT: OBJECTIVE:To identify differences between independent treatment centers (ITCs) and general hospitals (GHs) regarding costs, quality of care, and efficiency. DATA SOURCES:Anonymous claims data (2013-2015) were used. We also obtained quality indicators from a semipublic platform. STUDY DESIGN:This study uses a comparative multilevel analysis, controlling for case mix, to evaluate the performance of ITCs and GHs for patients diagnosed with cataract. DATA COLLECTION:Reimbursement claims were extracted from existing claims databases of the largest Dutch health insurer. Quality indicators were obtained by external agencies through a mixed-mode survey. PRINCIPAL FINDINGS:There are no stark differences in complexity of cases for cataract care. ITCs seem to perform surgeries more frequently per care pathway, but conduct a lower number of health care activities per surgical claim. Total average costs are lower in ITCs compared with GHs, but when adjusted for case mix, the differences in costs are lower. The findings with the adjusted quality differences suggest that ITCs outperform GHs on patient satisfaction, but patients' outcomes are similar. CONCLUSION:This finding supports the postulation-based on the focus factory theory-that ITCs can provide more value for cataract care than GHs.

SUBMITTER: Kruse FM

PROVIDER: S-EPMC6863231 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Do independent treatment centers offer more value than general hospitals? The case of cataract care.

Kruse Florien M FM Groenewoud Stef S Atsma Femke F van der Galiën Onno P OP Adang Eddy M M EMM Jeurissen Patrick P T PPT

Health services research 20190820 6

<h4>Objective</h4>To identify differences between independent treatment centers (ITCs) and general hospitals (GHs) regarding costs, quality of care, and efficiency.<h4>Data sources</h4>Anonymous claims data (2013-2015) were used. We also obtained quality indicators from a semipublic platform.<h4>Study design</h4>This study uses a comparative multilevel analysis, controlling for case mix, to evaluate the performance of ITCs and GHs for patients diagnosed with cataract.<h4>Data collection</h4>Reim ...[more]

PMID: 31429482

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Project description:BackgroundStrengthening the capacity of hospitals to take into account the level of health literacy of their public is a necessity to improve the quality of care. One way to develop adequate health literacy responsive policy and strategies in hospitals is the use of self-assessment tools to raise awareness, help prioritise action and mobilise stakeholders. The Vienna Health Literate Organisation (V-HLO) questionnaire, recently translated and adapted into French, is designed to meet this objective. In this study we have piloted the French version of the V-HLO (V-HLO-fr) tool in the main hospitals of Liège (Belgium) to explore its feasibility and gain a first insight into the strengths and weaknesses of the health literacy responsiveness of the participating hospitals.MethodsWe performed explorative case studies in three hospitals. Our mode of application of the V-HLO-fr was inspired by the 'RAND Appropriateness' method: first, individual members of an internal multidisciplinary panel filled out the questionnaire and then the results were discussed collectively in each hospital during a 'round table' meeting. The feasibility of the process was assessed by direct observation of the round tables and with semi-structured phone interviews.ResultsThe V-HLO-fr tool was fully applied in the three targeted hospitals and the process seems to be acceptable, practicable and integrable. Strengths (e.g. the facilitation of patient navigation to the hospital) and weaknesses (e.g. the provision of easy to read, understand and act on health information materials) in terms of health literacy responsiveness have been highlighted.ConclusionV-HLO-fr can be a suitable tool for a needs assessment that allows hospitals to create awareness and formulate targeted actions to further strengthen their health literacy responsiveness. Its mode of application, formalised by taking inspiration from the RAND method, could be further improved by paying more attention to recruiting and supporting participants. The V-HLO-fr and its added value in real-world projects should now be further tested in a larger number of hospitals.

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Do independent treatment centers offer more value than general hospitals? The case of cataract care.

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Do independent treatment centers offer more value than general hospitals? The case of cataract care.

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