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The impact of HMO penetration on the relationship between nurse staffing and quality

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Author Info

  • Barbara A. Mark

    (School of Nursing, University of North Carolina at Chapel Hill, NC, USA)

  • David W. Harless

    (Department of Economics, Virginia Commonwealth University, Richmond, VA, USA)

  • Michael McCue

    (Department of Health Administration, Virginia Commonwealth University, Richmond, VA, USA)

Abstract

While there are a number of studies examining the relationship between nurse staffing and quality, none has examined structural differences in the relationship between nurse staffing and quality contingent upon the level of managed care penetration. We used administrative data, and a dynamic panel data model to examine this relationship in a panel of 422 acute care hospitals from 1990 to 1995. We found that there were significant differences in the relationship between nurse staffing and both mortality and length of stay depending upon the level of HMO penetration in the hospital's market. Copyright © 2005 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.988
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 14 (2005)
Issue (Month): 7 ()
Pages: 737-753

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Handle: RePEc:wly:hlthec:v:14:y:2005:i:7:p:737-753

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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  1. Mark B. McClellan & Douglas O. Staiger, 2000. "Comparing Hospital Quality at For-Profit and Not- for-Profit Hospitals," NBER Chapters, National Bureau of Economic Research, Inc, in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 93-112 National Bureau of Economic Research, Inc.
  2. Shen, Yu-Chu, 2003. "The effect of financial pressure on the quality of care in hospitals," Journal of Health Economics, Elsevier, Elsevier, vol. 22(2), pages 243-269, March.
  3. Sloan, Frank A. & Picone, Gabriel A. & Taylor, Donald H., Jr. & Chou, Shin-Yi, 2000. "Hospital Ownership and Cost and Quality of Care: Is There a Dime's Worth of Difference?," Working Papers, Duke University, Department of Economics 00-11, Duke University, Department of Economics.
  4. Arellano, Manuel & Bond, Stephen, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," Review of Economic Studies, Wiley Blackwell, Wiley Blackwell, vol. 58(2), pages 277-97, April.
  5. Michelle M. Mello & Sally C. Stearns & Edward C. Norton, 2002. "Do Medicare HMOs still reduce health services use after controlling for selection bias?," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 11(4), pages 323-340.
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Cited by:
  1. Hsueh-Fen Chen & Gloria Bazzoli & Hui-Min Hsieh, 2009. "Hospital Financial Conditions and the Provision of Unprofitable Services," Atlantic Economic Journal, International Atlantic Economic Society, International Atlantic Economic Society, vol. 37(3), pages 259-277, September.

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