Page 97 - Effective healthcare cost containment policies Using the Netherlands as a case study - Niek W. Stadhouders
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N=13,618
The marginal benefits of healthcare spending in the Netherlands
means that exogenous QALY gains are not reflected in patient group QALY levels, and changes in patient QALY scores may be fully attributed to the health sector.
 Tables 4.6 and 4.7 show the results of the regression on the questionnaires database. The regressions also estimate that on average a male resp. female patient that visited the hospital has 0.08 (se=0.005) and 0.10 (se=0.008) fewer QALYs than the population that did not visit the hospital, corrected for age, demography, time and gender. Females have 0.03 lower QALY rating on average, while all QALY ratings improve over time by 0.005. The number of persons in an age group does not have a significant effect on the QALY rating.
F(6,13611) = 170.35 Prob>F=0.000 R =0.0817
variable Coefficient Standard error t-value p-value 95% confidence
 Table 4.6: health questionnaire regression results
2
                   Gender -0.02936 0.00508 -5.78 Patient -0.08016 0.00509 -15.74 -0.01870 0.07553 -2.48
interval
0.000 [-0.0393;-0.0194]
                  Patient x Gender
                  Time trend 0.00455 0.00146 3.11 Age -0.01332 0.00481 -2.77 Demographics 5.86*10-8 5.84*10-8 1.00
0.000 [-0.0901;-0.0702] 0.013 [-0.0335;-0.0039]
              Constant
-8.09640 2.91358                   -2.78
0.002 [0.0017;0.0074] 0.006 [-0.0227;-0.0039] 0.315 [-5.6*10-8; 1.7*10-7] 0.005             [-13.807;-2.385]
                N=8,071
F(20,8071) = . Prob>F=. Coefficient Robust standard t-value
R =0.0461 p-value           95% confidence
Table 4.7: health questionnaire of patients regression results
2
             variable
51 to 55 years 0.00167 56 to 60 years 0.00166 61 to 65 years 0.00167 66 to 70 years 0.00169 71 to 75 years 0.00168 76 to 80 years 0.00167 81 to 85 years 0.00165 86 to 90 years 0.00165 91 to 95 years 0.00157 95+ years 0.00148 51 to 55 years 0.00164 56 to 60 years 0.00166 61 to 65 years 0.00167 66 to 70 years 0.00167 71 to 75 years 0.00166 76 to 80 years 0.00163 81 to 85 years 0.00161 86 to 90 years 0.00157 91 to 95 years 0.00159 95+ years         0.00141
error
interval
0.484 [-0.0030;0.0064]
Gender (male)
                                                           Gender (female)
0.00239 0.70
0.00238 0.70 0.487 [-0.0030;0.0063] 0.00238 0.70         0.482       [-0.0030;0.0063] 0.00238 0.71 0.478 [-0.0030;0.0063] 0.00237 0.71         0.478       [-0.0030;0.0063] 0.00237 0.71 0.480 [-0.0030;0.0063] 0.00236 0.70         0.486       [-0.0030;0.0063] 0.00236 0.70 0.485 [-0.0030;0.0063] 0.00236 0.67         0.505       [-0.0031;0.0062] 0.00235 0.63 0.530 [-0.0031;0.0061] 0.00239 0.69         0.493       [-0.0030;0.0063] 0.00238 0.70 0.487 [-0.0030;0.0063] 0.00238 0.69         0.488       [-0.0030;0.0063] 0.00238 0.70 0.484 [-0.0030;0.0063] 0.00237 0.70         0.486       [-0.0030;0.0063] 0.00237 0.69 0.491 [-0.0030;0.0063] 0.00237 0.68         0.496       [-0.0030;0.0063] 0.00236 0.66 0.506 [-0.0031;0.0062] 0.00236 0.67         0.500       [-0.0030;0.0062] 0.00236 0.60 0.549 [-0.0030;0.0060]
                                                   demographics 7.26*10-8 constant               -2.5815
1.58*10-7 0.46         0.646       [-2.4*10-7;3.8*10-7] 4.7419 -0.54         0.586       [-11.877;6.714]
       Estimated annual health gain of patients is between 0.0014 and 0.0016 (se=0.0024) QALYs per year, depending on gender and age (table 4.7).These estimates are not significant and
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