Le coût unitaire de l'activité hospitalière publique en 1997 : le poids des déterminants régionaux

Abstract

The unit cost of hospital activity, measured by the value of the synthetic activity index, appears to vary substantially among hospitals, which are financed though lump sum transfers. The aim of the papers is to identify elements able to explain this variability, as such as activity indicators of the establishments (ratio of non medical personnel, dispersion of activity, gravity of the stays) and environmental indicators (regional value of the index, rate of unemployment and life expectancy). The estimated model gives a two-step like determination of the synthetic activity index of the establishments. First, the regional value of the index is determined by care supply and demand factors; the ratio of non medical personnel appears to depend on the one hand the size and the category of the establishments, and on the other hand on the index of average seriousness of the stays. Second, factors specific to the establishments (size and statute, dispersion of medical activity) are added the regional index value and to the ratio of non medical personnel in order to explain the index values of the establishments.