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Effects of report cards on referral patterns to cardiac surgeons

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  • Epstein, Andrew J.
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    Abstract

    Patients' choices of specialist physicians may be guided by referring physicians and report cards. I examine referral patterns to cardiac surgeons to assess whether publication of the May 2002 edition of Pennsylvania's Guide to Coronary Artery Bypass Graft Surgery added information to what referring physicians already knew. To do so, I developed a counterfactual scenario, including a simulated analogue report card, based on comparable data from Florida, a state without CABG report cards. My analysis failed to detect a significant change in referral patterns to either low-mortality or high-mortality cardiac surgeons. At the same time, referring physicians on average appear to have been knowledgeable about the relative performance of cardiac surgeons without report cards. Future report card efforts might benefit from incorporating the quality signals contained in referral patterns.

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    Bibliographic Info

    Article provided by Elsevier in its journal Journal of Health Economics.

    Volume (Year): 29 (2010)
    Issue (Month): 5 (September)
    Pages: 718-731

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    Handle: RePEc:eee:jhecon:v:29:y:2010:i:5:p:718-731

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    Web page: http://www.elsevier.com/locate/inca/505560

    Related research

    Keywords: Report cards Cardiac surgery Referral patterns;

    References

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    1. Jin, Ginger Zhe & Sorensen, Alan T., 2006. "Information and consumer choice: The value of publicized health plan ratings," Journal of Health Economics, Elsevier, vol. 25(2), pages 248-275, March.
    2. Pope, Devin G., 2009. "Reacting to rankings: Evidence from "America's Best Hospitals"," Journal of Health Economics, Elsevier, vol. 28(6), pages 1154-1165, December.
    3. Cutler, David & Landrum, Mary Beth & Huckman, Robert, 2004. "The Role of Information in Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Surgery," Scholarly Articles 2640582, Harvard University Department of Economics.
    4. David Revelt & Kenneth Train, 1998. "Mixed Logit With Repeated Choices: Households' Choices Of Appliance Efficiency Level," The Review of Economics and Statistics, MIT Press, vol. 80(4), pages 647-657, November.
    5. David M. Cutler & Robert S. Huckman & Mary Beth Landrum, 2004. "The Role of Information in Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Surgery," NBER Working Papers 10489, National Bureau of Economic Research, Inc.
    6. Brownstone, David & Train, Kenneth, 1999. "Forecasting new product penetration with flexible substitution patterns," University of California Transportation Center, Working Papers qt3tb6j874, University of California Transportation Center.
    7. Hole, Arne Risa, 2008. "Modelling heterogeneity in patients' preferences for the attributes of a general practitioner appointment," Journal of Health Economics, Elsevier, vol. 27(4), pages 1078-1094, July.
    8. Dranove, David & Sfekas, Andrew, 2008. "Start spreading the news: A structural estimate of the effects of New York hospital report cards," Journal of Health Economics, Elsevier, vol. 27(5), pages 1201-1207, September.
    9. Daniel McFadden & Kenneth Train, 2000. "Mixed MNL models for discrete response," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 15(5), pages 447-470.
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    Cited by:
    1. Hendrik Schmitz & Magdalena Stroka, 2014. "Do Elderly Choose Nursing Homes by Quality, Price or Location?," Ruhr Economic Papers 0495, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    2. Andrew J. Epstein & Sean Nicholson & David A. Asch, 2013. "The Production of and Market for New Physicians' Skill," NBER Working Papers 18678, National Bureau of Economic Research, Inc.
    3. Andrew Epstein & Scott Johnson, 2012. "Physician response to financial incentives when choosing drugs to treat breast cancer," International Journal of Health Care Finance and Economics, Springer, vol. 12(4), pages 285-302, December.
    4. Varkevisser, Marco & van der Geest, Stéphanie A. & Schut, Frederik T., 2012. "Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands," Journal of Health Economics, Elsevier, vol. 31(2), pages 371-378.
    5. Yijuan Chen, 2009. "Why Are Health Care Report Cards So Bad (Good)?," ANU Working Papers in Economics and Econometrics 2009-511, Australian National University, College of Business and Economics, School of Economics.
    6. Jason Hockenberry & Lorens Helmchen, 2014. "The Nature of Surgeon Human Capital Depreciation," NBER Working Papers 20017, National Bureau of Economic Research, Inc.

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