Constructing a volume index for hospital services in the Netherlands.

For medical services, in particular hospital services, it is very difficult to separate price and volume changes. In theory, the unit of production should be "the treatment". However, the practical implementation of this principle is not straightforward. This paper describes the development of a volume index for hospital care based on the national Hospital Discharge Register (HDR). Partial volume indicators are based on the number of discharges per diagnosis/age group. As much as 7000 diagnosis/age groups are distinguished, resulting from cross-classifying 1000 ICD (International Classification of Diseases) diagnoses and 7 age groups. The number of discharges from clinical and day treatment per group is counted. Weighting factors are approximated by the total number of hospitalisation days per group because no price information per treatment was available. The paper discusses the assumptions made and the problems related to the application of the volume index in the National Accounts. [ABSTRACT FROM AUTHOR]