Economic analysis of hospital-related factors affecting readmissions for hip replacement surgery: The case of Turkish hospitals

This dissertation examines the issue of hospital readmissions, which has gained prominence in health economics in recent years. Hospital readmissions are one of the causes of escalating healthcare expenditures. Avoidable expenditure increases can be mitigated by improving service quality. In this context, this study analyzes the relationship between the number of patients readmitted to the hospital within two months following hip replacement surgery and hospital characteristics. Study utilizes data from all hospitals (764 in total) that performed hip replacement surgeries in Türkiye in 2019. Among the count data models, the Zero-Inflated Negative Binomial Model has been used as the most suitable method of estimation for the distribution of data in hand. The estimation results have been improved by including exposure and interaction terms. This study found statistically significant relationships between the number of readmitted hip replacement patients and the following variables: hospital type, number of hip replacement surgeries, number of nurses per hip replacement surgery, bed occupancy rate, number of qualified beds and the interaction term formed by hospital type and the number of qualified beds. Moreover, the number of hip replacement surgeries and the average length of stay after hip replacement surgery are significantly related to hospitals falling into the structural zero group. Keywords: Count Data, Health Economics, Hospital Readmissions, Türkiye, Zero-Inflated Negative Binomial Model