A comparison of hospital administrative costs in eight nations: Us costs exceed all others by far

Health Affairs

Volumn 33, Issue 9, 2014, Pages 1586-1594

  Himmelstein, David U ^a,b   Jun, Miraya ^c   Busse, Reinhard ^d   Chevreul, Karine ^e,f   Geissler, Alexander ^g   Jeurissen, Patrick ^h   Thomson, Sarah ^c,i   Vinet, Marie Amelie ^e,f   Woolhandler, Steffie ^a,b  

^a CITY UNIVERSITY OF NEW YORK   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c LONDON SCHOOL OF ECONOMICS   (United Kingdom)

^d WORLD HEALTH ORGANIZATION   (Switzerland)

^e Paris Health Services and Health Economics Research UnitAssistance Publique Ho pitaux de Paris (the Paris area's University Medical Center)   (France)

^f INSERM   (France)

^g TECHNISCHE UNIVERSITÄT BERLIN   (Germany)

^h RADBOUD UNIVERSITY MEDICAL CENTER   (Netherlands)

ⁱ EUROPEAN OBSERVATORY ON HEALTH SYSTEMS AND POLICIES   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BUDGET; CANADA; CAPITAL; COMPARATIVE STUDY; FRANCE; FUNDING; GERMANY; HEALTH CARE POLICY; HEALTH INSURANCE; HOSPITAL ADMINISTRATIVE COST; HOSPITAL COST; HOSPITAL MANAGEMENT; HOSPITAL RUNNING COST; NATIONAL HEALTH SERVICE; NETHERLANDS; PUBLIC HEALTH SERVICE; UNITED KINGDOM; UNITED STATES; COST; ECONOMICS; ENGLAND; HUMAN; POLICY; SCOTLAND; WALES;

CANADA; COSTS AND COST ANALYSIS; ENGLAND; FRANCE; GERMANY; HOSPITAL ADMINISTRATION; HUMANS; NETHERLANDS; ORGANIZATIONAL POLICY; SCOTLAND; UNITED STATES; WALES;

EID: 84907062030     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2013.1327     Document Type: Article

References (31)

1. Organization for Economic Cooperation and Development. OECD health statistics 2014 [Internet]. Paris: OECD; [cited 2014 Jul 23]. Available from: http://www.oecd.org/els/health-systems/healthdata.htm
2. Squires DA. Explaining high health care spending in the United States: an international comparison of supply, utilization, prices, and quality [Internet]. New York (NY): Commonwealth Fund; 2012 May [cited 2014 May 7]. Available from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/May/1595_Squires_explaining_high_hlt_care_spending_intl_brief.pdf
3. Starfield B, Shi L, Macinko J. Contribution of primary care to health systems and health. Milbank Q. 2005;83(3):457-502.
4. Patented Medicine Prices Review Board. Annual report 2010: comparison of Canadian prices to foreign prices [Internet]. Ottawa (ON): PMPRB; [last modified 2011 Jun 9; cited 2014 May 7]. Available from: http://www.pmprb-cepmb.gc.ca/english/view.asp?x=1503&mid=1331
5. Laugesen MJ, Glied SA. Higher fees paid to US physicians drive higher spending for physician services compared to other countries. Health Aff (Millwood). 2011;30(9):1647-56.
6. Office of Technology Assessment. International comparisons of administrative costs in health care [Internet]. Washington (DC): Government Printing Office; 1994 Sep [cited 2014 May 7]. (Pub. No. OTABP-H-135). Available from: http:// govinfo.library.unt.edu/ota/Ota_1/ DATA/1994/9417.PDF
7. Himmelstein DU, Woolhandler S. Cost without benefit. Administrative waste in U.S. health care. N Engl J Med. 1986;314(7):441-5.
8. Himmelstein DU, Lewontin JP, Woolhandler S. Who administers? Who cares? Medical administrative and clinical employment in the United States and Canada. Am J Public Health. 1996;86(2):172-8.
9. Woolhandler S, Campbell T, Himmelstein DU. Costs of health care administration in the United States and Canada. N Engl J Med. 2003;349(8):768-75.
10. Pozen A, Cutler DM. Medical spending differences in the United States and Canada: the role of prices, procedures, and administrative expenses. Inquiry. 2010;47(2):124-34.
11. Cutler DM, Ly DP. The (paper) work of medicine: understanding international medical costs. J Econ Perspect. 2011;25(2):3-25.
12. Casalino LP, Nicholson S, Gans DN, Hammons T, Morra D, Karrison T, et al. What does it cost physician practices to interact with health insurance plans? Health Aff (Millwood). 2009;28(4):w533-43. DOI: 10.1377/hlthaff.28.4.w533.
13. Kahn JG. Excess billing and insurance-related administrative costs. In: Yong PL, Saunders RS, Olsen LA, editors. The healthcare imperative: lowering costs and improving outcomes: workshop series summary. Washington (DC): National Academies Press; 2010. p. 142-51.
14. To access the Appendix, click on the Appendix link in the box to the right of the article online.
15. Worldsalaries.org. International average salary income database: office clerk salaries-international comparison [Internet]. [place unknown]: Worldsalaries.org; c2008 [cited 2014 May 7]. Available from: http://www.worldsalaries.org/ officeclerk.shtml
16. Bureau of Labor Statistics. International comparisons of hourly compensation costs in manufacturing, 2012 [Internet]. Washington (DC): Department of Labor; 2013 Aug 9 [cited 2014 May 7]. Available from: http://www.bls.gov/fls/ichcc.pdf
17. Boyle S. United Kingdom (England): health system review. Health Syst Transit. 2011;13(1):1-483.
18. Maarse H, Jeurissen P, Ruwaard D. Concerns over the financial sustainability of the Dutch healthcare system. CESifo DICE Report. 2013; 11(1):32-36.
19. Reinhardt UE. The many different prices paid to providers and the flawed theory of cost shifting: is it time for a more rational all-payer system? Health Aff (Millwood). 2011;30(11):2125-33.
20. Maryland Hospital Association. Achievement, access, and accountability: Maryland's all-payor hospital payment system [Internet]. Elkridge (MD): The Association; [cited 2014 May 7]. Available from: http://www.hscrc.state.md.us/documents/ HSCRC_PolicyDocumentsReports/ GeneralInformation/AshbyReport 2007.pdf
21. Hawe E,Yuen P, Baillie L. OHE guide to UK health and health care statistics. London: Office of Health Economics; 2011 Jul.
22. Silverman E, Skinner J. Medicare upcoding and hospital ownership. J Health Econ. 2004;23(2):369-89.
23. Woolhandler S, Himmelstein DU. Costs of care and administration at for-profit and other hospitals in the United States. N Engl J Med. 1997; 336(11):769-74.
24. Silverman EM, Skinner JS, Fisher ES. The association between forprofit hospital ownership and increased Medicare spending. N Engl J Med. 1999;341(6):420-6.
25. Devereaux PJ, Heels-Ansdell D, Lacchetti C, Haines T, Burns KE, Cook DJ, et al. Payments for care at private for-profit and private not-forprofit hospitals: a systematic review and meta-analysis. CMAJ. 2004; 170(12):1817-24.
26. Tiemann O, Schreyo¨gg J, Busse R. Hospital ownership and efficiency: a review of studies with particular focus on Germany. Health Policy. 2012;104(2):163-71.
27. Danzon PM. Hidden overhead costs: is Canada's system really less expensive? Health Aff (Millwood). 1992;11(1):21-43.
28. Devereaux PJ, Choi PT, Lacchetti C, Weaver B, Schu¨nemann HJ, Haines T, et al. A systematic review and meta-analysis of studies comparing mortality rates of private for-profit and private not-for-profit hospitals. CMAJ. 2002;166(11):1399-406.
29. Jha AK, Orav EJ, Epstein AM. Lowquality, high-cost hospitals, mainly in the South, care for sharply higher shares of elderly black, Hispanic, and Medicaid patients. Health Aff (Millwood). 2011;30(10):1904-11.
30. Jha AK, Orav EJ, Zheng J, Epstein AM. Patients' perception of hospital care in the United States. N Engl J Med. 2008;359:1921-31.
31. National Research Council. U.S. health in international perspective: shorter lives, poorer health. Washington (DC): National Academies Press; 2013.