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Can We Measure Hospital Quality from Physicians' Choices?

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  • Machado, Matilde Pinto
  • Mora, Ricardo
  • Romero-Medina, Antonio

Abstract

In this paper, we propose an alternative methodology for ranking hospitals based on the choices of Medical School graduates over hospital training vacancies. Our methodology is therefore a revealed preference approach. Our methodology for measuring relative hospital quality has the following desirable properties: a) robust to manipulation from hospital administrators; b) conditional on having enough observations, it allows for differences in quality across specialties within a hospital; c) inexpensive in terms of data requirements, d) not subject to selection bias from patients nor hospital screening of patients; and e) unlike other rankings based on experts' evaluations, it does not require physicians to provide a complete ranking of all hospitals. We apply our methodology to the Spanish case and find, among other results, the following: First, the probability of choosing the best hospital relative to the worst hospital is statistically significantly different from zero. Second, physicians value proximity and nearby hospitals are seen as more substitutable. Third, observable time-invariant city characteristics are unrelated to results. Finally, our estimates for physicians' hospital valuations are significantly correlated to more traditional hospital quality measures.

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Paper provided by C.E.P.R. Discussion Papers in its series CEPR Discussion Papers with number 6850.

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Date of creation: Jun 2008
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Handle: RePEc:cpr:ceprdp:6850

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Keywords: Hospital Quality; Hospital Rankings; Nested Logit; Physicians' Labour Market; Revealed Preference;

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References

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Cited by:
  1. Csató, László, 2013. "Rangsorolás páros összehasonlításokkal. Kiegészítések a felvételizői preferencia-sorrendek módszertanához
    [Paired comparisons ranking. A supplement to the methodology of application-bas
    ," Közgazdasági Szemle (Economic Review - monthly of the Hungarian Academy of Sciences), Közgazdasági Szemle Alapítvány (Economic Review Foundation), vol. 0(12), pages 1333-1353.
  2. Jeffrey E. Harris & Beatriz G. López-Valcárcel & Patricia Barber & Vicente Ortún, 2014. "Efficiency versus Equity in the Allocation of Medical Specialty Training Positions in Spain: A Health Policy Simulation Based on a Discrete Choice Model," NBER Working Papers 19896, National Bureau of Economic Research, Inc.

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