Costs of care and administration at for-profit and other hospitals in the United States.
Background In fiscal year 1990, administration accounted for 24.8 percent of total hospital costs in the United States - nearly twice the share in Canada.
Studies from the 1970s and early 1980s found high costs, especially for administration, at for-profit hospitals.
Methods We calculated administrative costs for 6227 nonfederal hospitals and the total costs of inpatient care for 5201 acute care hospitals in the United States for fiscal year 1994 on the basis of data the hospitals submitted to Medicare.
We analyzed similar data for fiscal year 1990.
Using multivariate analysis, we assessed the effect of hospital ownership (private not-for-profit, for-profit, and public) on administrative costs, controlling for hospital type, census region, hospital size, and the proportion of revenues derived from outpatient services.
We adjusted inpatient costs for local wage levels, hospitals'reporting periods, and case mix.
Results Administrative costs accounted for an average of 26.0 percent of total hospital costs in fiscal year 1994, up 1.2 percentage points from 1990.
They increased by 2.2 percentage points, to 34.0 percent, for for-profit hospitals ; by 1.2 percentage points, to 24.5 percent, for private not-for-profit hospitals ; and by 0.6 percentage point, to 22.9 percent, for public hospitals.
In 1994, administration accounted for 37.5 percent of total costs at psychiatric hospitals (44.4 percent at for-profit hospitals) and 33. (...)
Mots-clés Pascal : Hôpital, Administration publique, Rapport coût bénéfice, Soin santé primaire, Etude comparative, Critère sélection, Gestion administrative, Analyse statistique, Evaluation, Homme, Organisation santé, Economie santé, Politique sanitaire
Mots-clés Pascal anglais : Hospital, Civil service, Cost benefit ratio, Primary health care, Comparative study, Selection criterion, Administrative management, Statistical analysis, Evaluation, Human, Public health organization, Health economy, Health policy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0219774
Code Inist : 002B30A04B. Création : 21/05/1997.