Authors: Dimitris Tziallas, Catherine Kastanioti, Konstantinos Kirkos, Konstantinos Exarchos, Vasilis Tsimihodimos, Moses Elisaf

Title: Evaluating the relationship between hospital cost and quality indices in a NHS hospital in Greece

Abstract

Due to the economic crisis the Greek Health System is facing challenges on two fronts: reduction of hospital cost and concerns about care quality. However, the relationship between quality improvement and cost reduction is complex and not yet clear.

The aim of the study was to assess whether care quality and cost reduction are complementary to or in competition with one another.

New hospitalized patients who admitted to an internal medicine clinic of a teaching hospital were included in the study. Quality was assessed by a validated patient satisfaction’s questionnaire including data on fifteen performance indicators, approved by Hospital Quality Commission. Moreover, hospital costs were calculated using data from esy.net for fiscal year 2008 till 2013.

The relationship between hospital’s cost of care and its quality was weak. Specifically, according to the results there was a reduction of mean quality score (4,29/5 for year 2008 till 3,30/5 for year 2011, year of health care reforms), and then a slightly increase (4,00/5 for year 2014). On the contrary, total hospital cost follows a reduction from 2008 (514.806€) to 2013 (239.335 €).

Our study did not support the “penny wise and pound foolish” hypothesis that low-cost hospital have lower quality indices.