IDEAS home Printed from https://ideas.repec.org/p/mhe/chemon/2022-01.html
   My bibliography  Save this paper

Is Hospital Quality Predictive of Pandemic Deaths? Evidence from US Counties

Author

Listed:
  • Johannes S. Kunz

    (Monash Business School)

  • Carol Propper

    (Imperial College London)

Abstract

In the large literature on the spatial-level correlates of COVID-19, the association between quality of hospital care and outcomes has received little attention to date. To examine whether county-level mortality is correlated with measures of hospital performance, we assess daily cumulative deaths and pre-crisis measures of hospital quality, accounting for state fixed-effects and potential confounders. As a measure of quality, we use the pre-pandemic adjusted five-year penalty rates for excess 30-day readmissions following pneumonia admissions for the hospitals accessible to county residents based on ambulance travel patterns. Our adjustment corrects for socio-economic status and down-weighs observations based on small samples. We find that a one-standard-deviation increase in the quality of local hospitals is associated with a 2% lower death rate (relative to the mean of 20 deaths per 10,000 people) one and a half years after the first recorded death.

Suggested Citation

  • Johannes S. Kunz & Carol Propper, 2022. "Is Hospital Quality Predictive of Pandemic Deaths? Evidence from US Counties," Papers 2022-01, Centre for Health Economics, Monash University.
  • Handle: RePEc:mhe:chemon:2022-01
    as

    Download full text from publisher

    File URL: http://monash-ch-econ-wps.s3-ap-southeast-2.amazonaws.com/RePEc/mhe/chemon/2022-01.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Chernozhukov, Victor & Kasahara, Hiroyuki & Schrimpf, Paul, 2021. "Causal impact of masks, policies, behavior on early covid-19 pandemic in the U.S," Journal of Econometrics, Elsevier, vol. 220(1), pages 23-62.
    2. Dhaval M. Dave & Andrew I. Friedson & Kyutaro Matsuzawa & Joseph J. Sabia & Samuel Safford, 2020. "Were Urban Cowboys Enough to Control COVID-19? Local Shelter-in-Place Orders and Coronavirus Case Growth," NBER Working Papers 27229, National Bureau of Economic Research, Inc.
    3. McLaren John, 2021. "Racial Disparity in COVID-19 Deaths: Seeking Economic Roots with Census Data," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 21(3), pages 897-919, July.
    4. Christopher J. Ruhm, 2021. "Excess Deaths in the United States During the First Year of COVID-19," NBER Working Papers 29503, National Bureau of Economic Research, Inc.
    5. Johannes S. Kunz & Kevin E. Staub & Rainer Winkelmann, 2021. "Predicting individual effects in fixed effects panel probit models," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 184(3), pages 1109-1145, July.
    6. Debasree Das Gupta & Uma Kelekar & Sidney C Turner & Anupam A Sule & Taya G Jerman, 2021. "Interpreting COVID-19 deaths among nursing home residents in the US: The changing role of facility quality over time," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-13, September.
    7. Marcella Alsan & Amitabh Chandra & Kosali Simon, 2021. "The Great Unequalizer: Initial Health Effects of COVID-19 in the United States," Journal of Economic Perspectives, American Economic Association, vol. 35(3), pages 25-46, Summer.
    8. John M. Barrios & Efraim Benmelech & Yael V. Hochberg & Paola Sapienza & Luigi Zingales, 2020. "Civic Capital and Social Distancing during the Covid-19 Pandemic," NBER Working Papers 27320, National Bureau of Economic Research, Inc.
    9. Christopher R. Knittel & Bora Ozaltun, 2020. "What Does and Does Not Correlate with COVID-19 Death Rates," NBER Working Papers 27391, National Bureau of Economic Research, Inc.
    10. Desmet, Klaus & Wacziarg, Romain, 2020. "Understanding Spatial Variation in COVID-19 across the United States," CEPR Discussion Papers 14842, C.E.P.R. Discussion Papers.
    11. Bursztyn, Leonardo & Rao, Akaash & Roth, Christopher & Yanagizawa-Drott, David, 2020. "Misinformation during a Pandemic," The Warwick Economics Research Paper Series (TWERPS) 1274, University of Warwick, Department of Economics.
    12. Wenzhi Ding & Ross Levine & Chen Lin & Wensi Xie, 2020. "Social Distancing and Social Capital: Why U.S. Counties Respond Differently to COVID-19," NBER Working Papers 27393, National Bureau of Economic Research, Inc.
    13. Borjas, George J., 2020. "Demographic Determinants of Testing Incidence and COVID-19 Infections in New York City Neighborhoods," IZA Discussion Papers 13115, Institute of Labor Economics (IZA).
    14. George J. Borjas, 1980. "The Relationship between Wages and Weekly Hours of Work: The Role of Division Bias," Journal of Human Resources, University of Wisconsin Press, vol. 15(3), pages 409-423.
    15. Dionissi Aliprantis & Kristen Tauber, 2020. "Measuring Deaths from COVID-19," Economic Commentary, Federal Reserve Bank of Cleveland, vol. 2020(18), pages 1-7, July.
    16. Karen Clay & Joshua A. Lewis & Edson R. Severnini & Xiao Wang, 2020. "The Value of Health Insurance during a Crisis: Effects of Medicaid Implementation on Pandemic Influenza Mortality," NBER Working Papers 27120, National Bureau of Economic Research, Inc.
    17. Nicholas W. Papageorge & Matthew V. Zahn & Michèle Belot & Eline Broek-Altenburg & Syngjoo Choi & Julian C. Jamison & Egon Tripodi, 2021. "Socio-demographic factors associated with self-protecting behavior during the Covid-19 pandemic," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(2), pages 691-738, April.
    18. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    19. Joseph J. Doyle Jr. & John A. Graves & Jonathan Gruber & Samuel A. Kleiner, 2015. "Measuring Returns to Hospital Care: Evidence from Ambulance Referral Patterns," Journal of Political Economy, University of Chicago Press, vol. 123(1), pages 170-214.
    20. Abel Brodeur & Idaliya Grigoryeva & Lamis Kattan, 2021. "Stay-at-home orders, social distancing, and trust," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(4), pages 1321-1354, October.
    21. Skinner, Jonathan, 2011. "Causes and Consequences of Regional Variations in Health Care," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 45-93, Elsevier.
    22. Joseph Doyle & John Graves & Jonathan Gruber, 2019. "Evaluating Measures of Hospital Quality: Evidence from Ambulance Referral Patterns," The Review of Economics and Statistics, MIT Press, vol. 101(5), pages 841-852, December.
    23. Jill Furzer & Boriana Miloucheva, 2020. "The Long Arm of the Clean Air Act: Pollution Abatement and COVID-19 Racial Disparities," Working Papers tecipa-668, University of Toronto, Department of Economics.
    24. Amy Finkelstein & Matthew Gentzkow & Heidi Williams, 2016. "Sources of Geographic Variation in Health Care: Evidence From PatientMigration," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(4), pages 1681-1726.
    25. Borgonovi, Francesca & Andrieu, Elodie, 2020. "Bowling together by bowling alone: Social capital and COVID-19," Social Science & Medicine, Elsevier, vol. 265(C).
    26. Craig Garthwaite & Christopher Ody & Amanda Starc, 2020. "Endogenous Quality Investments in the U.S. Hospital Market," NBER Working Papers 27440, National Bureau of Economic Research, Inc.
    27. Peter Zhixian Lin & Christopher M. Meissner, 2020. "A Note on Long-Run Persistence of Public Health Outcomes in Pandemics," NBER Working Papers 27119, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kunz, Johannes S. & Propper, Carol, 2023. "JUE Insight: Is hospital quality predictive of pandemic deaths? Evidence from US counties," Journal of Urban Economics, Elsevier, vol. 133(C).
    2. Abel Brodeur & David Gray & Anik Islam & Suraiya Bhuiyan, 2021. "A literature review of the economics of COVID‐19," Journal of Economic Surveys, Wiley Blackwell, vol. 35(4), pages 1007-1044, September.
    3. Johannes S. Kunz & Carol Propper & Kevin E. Staub & Rainer Winkelmann, 2023. "Assessing the Quality of Public Services: For-profits, Chains, and Concentration in the Hospital Market," Papers 2023-01, Centre for Health Economics, Monash University.
    4. Steven Stillman & Mirco Tonin, 2022. "Communities and testing for COVID-19," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(4), pages 617-625, June.
    5. Brandily, Paul & Brébion, Clément & Briole, Simon & Khoury, Laura, 2021. "A poorly understood disease? The impact of COVID-19 on the income gradient in mortality over the course of the pandemic," European Economic Review, Elsevier, vol. 140(C).
    6. Wright, Austin L. & Sonin, Konstantin & Driscoll, Jesse & Wilson, Jarnickae, 2020. "Poverty and economic dislocation reduce compliance with COVID-19 shelter-in-place protocols," Journal of Economic Behavior & Organization, Elsevier, vol. 180(C), pages 544-554.
    7. Simon Porcher & Thomas Renault, 2021. "Social distancing beliefs and human mobility: Evidence from Twitter," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-12, March.
    8. Joseph Benitez & Charles Courtemanche & Aaron Yelowitz, 2020. "Racial and Ethnic Disparities in COVID-19: Evidence from Six Large Cities," Journal of Economics, Race, and Policy, Springer, vol. 3(4), pages 243-261, December.
    9. Fuest, Clemens & Immel, Lea & Neumeier, Florian & Peichl, Andreas, 2023. "Does expert information affect citizens’ attitudes toward Corona policies? Evidence from Germany," European Journal of Political Economy, Elsevier, vol. 78(C).
    10. Elena Lucchese, 2020. "It could be worse...it could be raining: Ambulance response time and health outcomes," Working Papers 429, University of Milano-Bicocca, Department of Economics, revised Feb 2020.
    11. Bello, Piera & Rocco, Lorenzo, 2022. "Education and COVID-19 excess mortality," Economics & Human Biology, Elsevier, vol. 47(C).
    12. Shenoy, Ajay & Sharma, Bhavyaa & Xu, Guanghong & Kapoor, Rolly & Rho, Haedong Aiden & Sangha, Kinpritma, 2022. "God is in the rain: The impact of rainfall-induced early social distancing on COVID-19 outbreaks," Journal of Health Economics, Elsevier, vol. 81(C).
    13. Bensnes, Simon & Huitfeldt, Ingrid, 2021. "Rumor has it: How do patients respond to patient-generated physician ratings?," Journal of Health Economics, Elsevier, vol. 76(C).
    14. Desmet, Klaus & Wacziarg, Romain, 2022. "JUE Insight: Understanding spatial variation in COVID-19 across the United States," Journal of Urban Economics, Elsevier, vol. 127(C).
    15. Deopa, Neha & Fortunato, Piergiuseppe, 2021. "Coronagraben in Switzerland: Culture and social distancing in times of COVID-19," GLO Discussion Paper Series 857, Global Labor Organization (GLO).
    16. Menon, Nidhiya, 2021. "Does BMI predict the early spatial variation and intensity of Covid-19 in developing countries? Evidence from India," Economics & Human Biology, Elsevier, vol. 41(C).
    17. Neha Deopa & Piergiuseppe Fortunato, 2021. "Coronagraben in Switzerland: culture and social distancing in times of COVID-19," Journal of Population Economics, Springer;European Society for Population Economics, vol. 34(4), pages 1355-1383, October.
    18. Egorov, Georgy & Enikolopov, Ruben & Makarin, Alexey & Petrova, Maria, 2021. "Divided we stay home: Social distancing and ethnic diversity," Journal of Public Economics, Elsevier, vol. 194(C).
    19. Elena Lucchese, 2024. "How important are delays in treatment for health outcomes? The case of ambulance response time and cardiovascular events," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 652-673, April.
    20. Paul Brandily & Clément Brébion & Simon Briole & Laura Khoury, 2021. "A Poorly Understood Disease? The Evolution of the Income Gradient in Excess Mortality Due to COVID-19 within Urban Areas," Working Papers halshs-03154551, HAL.

    More about this item

    Keywords

    COVID-19; County-level Deaths; Hospital Quality; Health Care Systems;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:mhe:chemon:2022-01. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Daniel Avdic (email available below). General contact details of provider: https://edirc.repec.org/data/dxmonau.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.