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Multilevel analysis showed that variance in direct medical costs was not determined by differences between hospitals or hospital departments.
Therefore, we conclude that our results are not caused by differences between hospitals in quality of care.,, The interaction between patients and health care providers may have led to both appropriate or inappropriate excess LOS and unplanned readmissions (figure 1).
The strong correlation between the UL-LOS with and without carcinomas, and the low correlation between UL-LOS and discharging patients, seem to indicate that the UL-LOS is not influenced by differences between hospitals in the ability to admit patients to next care facilities.
Furthermore, for all selected diagnoses and procedures, care is mostly provided in an in-patient setting in the Netherlands (so the results were not influenced by differences between hospitals in the extent to which patients are treated in day care or outpatient care) and the volume was sufficient for reliable statistical analysis.
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This is also reflected in the high ICC of the association between type of hospital and complete protocol compliance, showing that 28% of the total variance in the association between type of hospital and complete protocol compliance was caused by differences between individual hospitals.
A reasonable percentage of the total variance in hydration was caused by differences between individual hospitals.
The ICC was 33.31, meaning that 33% of the total variance in the association between admission departments and hydration was caused by differences between individual hospitals.
The multi-level analysis shows that 19% (ICC = 18,89) of the total variance in hydration was caused by differences between individual hospitals.
In total, 34% (ICC=33.63) of the total variance in the association between department and complete protocol compliance was caused by differences between individual hospitals and 13% (ICC=13.01) by individual departments.
The multilevel analysis shows that 20% of the total variance in performed proceedings of the administration protocol (ICC=20.06) was caused by differences between individual hospitals and 10% of the variance in protocol compliance (ICC=9.55) was caused by differences between individual departments.
We analyse cost differences between hospitals by identification of cost drivers at two levels: patient level and department level.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com