Do Healthcare Report Cards Cause Providers To Select Patients And Raise Quality Of Care?
AbstractWe exploit a brief period of asymmetric information during the implementation of Pennsylvaniaâs âreport cardâ scheme for coronary artery bypass graft surgery to test for improvements in quality of care and selection of patients by health care providers. During the ?rst three years of the 1990s, providers in Pennsylvania had an incentive to bias report cards by selecting patients strategically, with patients having no access to the report cards. This dichotomy enables us to separate providersâ selection of patients from patientsâ selection of providers. Using data from the Nationwide Inpatient Sample, we estimate a nonâlinear differenceâinâ differences model and derive asymptotic standard errors. The mortality rate for bypass patients decreases by only 0.05 percentage points due to the report cards, which we interpret as evidence that quality of bypass surgery did not improve (at least in the shortâterm) nor did patient selection by providers occur. Our timing, estimation, and asymptotics are readily applicable to many other report card schemes.
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Bibliographic InfoArticle provided by John Wiley & Sons, Ltd. in its journal Health Economics.
Volume (Year): 21 (2012)
Issue (Month): (06)
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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749
Other versions of this item:
- Yijuan Chen & Juergen Meinecke, 2012. "Do Health Care Report Cards Cause Providers to Select Patients and Raise Quality of Care?," CEPR Discussion Papers 657, Centre for Economic Policy Research, Research School of Economics, Australian National University.
- C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Longitudinal Data; Spatial Time Series
- D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
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