FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 309:151-159 July 21, 1983 Number 3 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

This study documents the increases in real inputs (e.g., labor and equipment) employed in Ontario's hospital sector between 1968 and 1981--a period of universal government-financed hospital insurance and a government regulatory strategy involving global budgeting. Total expenditures in Ontario increased by only 16 per cent in terms of real inputs, as compared with an increase of 101 per cent in the United States. Real inputs per patient-day increased at a mean annual rate of 0.68 per cent in Ontario versus 5.19 per cent in the United States (P less than 0.001). Real inputs per admission decreased at a mean annual rate of 1.12 per cent in Ontario, as compared with an increase of 4.15 per cent in the United States (P less than 0.0001). We conclude that regulation can contain the growth of real inputs employed in the hospital sector even in the face of an incentive structure that does not promote cost consciousness on the part of patients or physicians. Although the effect of this strategy on the quality of care is unknown, so far it appears to have been politically acceptable in Ontario.

This article has been cited by other articles:

• Bell, C. M., Crystal, M., Detsky, A. S., Redelmeier, D. A. (1998). Shopping Around for Hospital Services: A Comparison of the United States and Canada. JAMA 279: 1015-1017 [Abstract] [Full Text]  
• Redelmeier, D. A., Fuchs, V. R. (1993). Hospital Expenditures in the United States and Canada. NEJM 328: 772-778 [Abstract] [Full Text]  
• Rouleau, J. L., Moye, L. A., Pfeffer, M. A., Arnold, J. M. O., Bernstein, V., Cuddy, T. E., Dagenais, G. R., Geltman, E. M., Goldman, S., Gordon, D., Hamm, P., Klein, M., Lamas, G. A., McCans, J., McEwan, P., Menapace, F. J., Parker, J. O., Sestier, F., Sussex, B., Braunwald, E., The SAVE Investigators, (1993). A Comparison of Management Patterns after Acute Myocardial Infarction in Canada and the United States. NEJM 328: 779-784 [Abstract] [Full Text]  
• Rice, T. (1992). Containing Health Care Costs in the United States. Med Care Res Rev 49: 19-65  
• Weiland, D. E. (1991). Comparative Uses and Cost for TPN in the United States, Canada, and the United Kingdom. JPEN J Parenter Enteral Nutr 15: 498-498  
• Evans, R. G. (1990). Tension, Compression, and Shear: Directions, Stresses, and Outcomes of Health Care Cost Control. Journal of Health Politics, Policy and Law 15: 101-128 [Abstract]  
• De Alessi, L. (1989). The Effect of Institutions on the Choices of Consumers and Providers of Health Care. Journal of Theoretical Politics 1: 427-458 [Abstract]  
• Bodenheimer, T. S. (1989). Payment Mechanisms under a National Health Program. Med Care Res Rev 46: 3-43  
• Himmelstein, D. U., Woolhandler, S. (1988). The Corporate Compromise: A Marxist View of Health Maintenance Organizations and Prospective Payment. ANN INTERN MED 109: 494-501 [Abstract]  
• RUSTHOVEN, J. J., WODINSKY, H., OSOBA, D. (1986). Canadian Cancer Care: Organizational Models. ANN INTERN MED 105: 932-936 [Abstract]  
• Detsky, A. S., Mclaughlin, J. R., Abrams, H. B., Whittaker, J. S., Whitwell, J., L'Abbe, K., Jeejeebhoy, K. N. (1986). A Cost-Utility Analysis of the Home Parenteral Nutrition Program at Toronto General Hospital: 1970-1982. JPEN J Parenter Enteral Nutr 10: 49-57 [Abstract]