Differences in length of stay for hip replacement between public hospitals, specialised treatment centres and private providers: selection or efficiency?

Health Econ. 2013 Feb;22(2):234-42. doi: 10.1002/hec.1826. Epub 2012 Jan 6.


We investigate differences in patients' length of stay between National Health Service (NHS) public hospitals, specialised public treatment centres and private treatment centres that provide elective (non-emergency) hip replacement to publicly funded patients. We find that the specialised public treatment centres and private treatment centres have, on average, respectively 18% and 40% shorter length of stay compared with NHS public hospitals, even after controlling for differences in age, gender, number and type of diagnoses, deprivation and regional variation. Therefore, we interpret such differences as because of efficiency as opposed to selection of less complex patients. Quantile regression suggests that the proportional differences between different provider types are larger at the higher conditional quantiles of length of stay.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip*
  • Female
  • Hospitals, Public*
  • Humans
  • Length of Stay / trends*
  • Linear Models
  • Male
  • Middle Aged
  • Models, Econometric
  • Private Sector*
  • State Medicine
  • Surgicenters*
  • United Kingdom
  • Young Adult