Recenti sviluppi nella metodologia statistica per la valutazione dell'efficacia degli ospedali

Abstract

In this paper the recent developments in methodology concerning the efficacy of hospitals are presented. The statistical model used in order to examine efficacy is the multilevel model. First of all, we present new proposals regarding the nature and the distribution of the observed indicators and of the outcomes, the casual variables concerning hospital efficacy, and the model as a whole. Secondly, we examine the debate on the choice of outcomes and observed indicators able to measure respectively efficacy and patient conditions preceding admission to hospital. A study concerning surgery patients in Lombard hospitals in 2000 illustrates an example of the operative and innovative consequences of our approach.