NESCOP (Including: Watson, Samuel I., Arulampalam, Wiji and Petrou, Stavros). (2017) The effect of health care expenditure on patient outcomes : evidence from English neonatal care. Health Economics, 26 (12). e274-e284. doi:10.1002/hec.3503 ISSN 1057-9230.

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Abstract

The relationship between health care expenditure and health outcomes has been the subject of recent academic inquiry in order to inform cost-effectiveness thresholds for health technology assessment agencies. Previous studies in public health systems have relied upon data aggregated at the national or regional level; however, there remains debate about whether the supply side effect of changes to expenditure are identifiable using data at this level of aggregation. We use detailed patient data derived from electronic neonatal records across England along with routinely available cost data to estimate the effect of changes to patient expenditure on clinical health outcomes in a well-defined patient population. A panel of 32 neonatal intensive care units for the period 2009–2013 was constructed. Accounting for the potential endogeneity of expenditure a £100 increase in the cost per intensive care cot day (sample average cost: £1,127) is estimated to reduce the risk of mortality of 0.38 percentage points (sample average mortality: 11.0%) in neonatal intensive care. This translates into a cost per life saved in neonatal intensive care of approximately £420,000.

Item Type:	Journal Article
Subjects:	R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Cell & Developmental Biology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Social Sciences > Economics Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Neonatal intensive care -- Cost effectiveness -- England
Journal or Publication Title:	Health Economics
Publisher:	John Wiley & Sons Ltd.
ISSN:	1057-9230
Official Date:	December 2017
Dates:	Date Event December 2017 Published 12 May 2017 Available 15 February 2017 Accepted
Volume:	26
Number:	12
Page Range:	e274-e284
DOI:	10.1002/hec.3503
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Date of first compliant deposit:	22 February 2017
Date of first compliant Open Access:	12 May 2018
Funder:	National Institute for Health Research (Great Britain). Applied Research Programme (ARP NIHR), Collaborations for Leadership in Applied Health Research and Care (CLAHRC), Great Britain. Department of Health (DoH), Groupe Danone, AbbVie (Firm), Abbott International, University of Warwick. Department of Economics
Grant number:	RP-PG-0707-10010 (ARP NIHR)

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