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Estimating the out-of-hospital mortality rate using patient discharge data

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  • Mehdi Farsi

    (Department of Management, Technology and Economics, ETH Zurich, Zurichbergstr. 18, Zurich, Switzerland)

  • Geert Ridder

    (Department of Economics, University of Southern California, University Park, Los Angeles, CA, USA)

Abstract

This paper explores the hospital quality measures based on routine administrative data such as patient discharge records. Most of the measures used in the literature are based on in-hospital mortality risks rather than post-discharge events. The in-hospital outcomes are sensitive to the hospital's discharge policy, thus could bias the quality estimates. This study aims at identifying out-of-hospital mortality risks and disentangling discharge and re-hospitalization rates from mortality rates using patient discharge data. It is shown that these objectives can be achieved without post-discharge death records. This is an example of the use of public use administrative data for estimating empirical relations when key dependent variables are not available. Using data on the lengths of hospitalizations and out-of-hospital spells, the mortality rates before and after discharge are estimated for a sample of heart-attack patients hospitalized in California between 1992 and 1998. The results suggest that the quality assessments that ignore the variation of discharge rates among hospitals could be misleading. Copyright © 2006 John Wiley & Sons, Ltd.

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Bibliographic Info

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

Volume (Year): 15 (2006)
Issue (Month): 9 ()
Pages: 983-995

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Handle: RePEc:wly:hlthec:v:15:y:2006:i:9:p:983-995

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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. Frank A. Sloan, 2002. "Hospital Ownership Conversions: Defining the Appropriate Public Oversight Role," NBER Chapters, National Bureau of Economic Research, Inc, in: Frontiers in Health Policy Research, Volume 5, pages 123-166 National Bureau of Economic Research, Inc.
  3. Janet Currie & Mehdi Farsi & W. Bentley Macleod, 2005. "Cut to the bone? Hospital takeovers and nurse employment contracts," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 58(3), pages 494-514, April.
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  5. Cutler, David M, 1995. "The Incidence of Adverse Medical Outcomes under Prospective Payment," Econometrica, Econometric Society, Econometric Society, vol. 63(1), pages 29-50, January.
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Cited by:
  1. Daysal, N. Meltem, 2012. "Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California," Discussion Paper, Tilburg University, Center for Economic Research 2012-027, Tilburg University, Center for Economic Research.
  2. Paul H. Jensen & Elizabeth Webster & Julia Witt, 2009. "Hospital type and patient outcomes: an empirical examination using AMI readmission and mortality records," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 18(12), pages 1440-1460.
  3. Jones, A.M, 2010. "Models For Health Care," Health, Econometrics and Data Group (HEDG) Working Papers, HEDG, c/o Department of Economics, University of York 10/01, HEDG, c/o Department of Economics, University of York.

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