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Physician Quality and Health Care for the Poor and Uninsured

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Author Info
Lara Bryant () (Department of Economics, College of Business, Florida Atlantic University)
Sharmila Vishwasrao () (Department of Economics, College of Business, Florida Atlantic University)

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Abstract

Many studies have documented adverse health outcomes for uninsured patients in U.S. hospitals. These poor outcomes have been attributed to their health status and limited access to healthcare. A measure of treatment that remains unexplored is the quality of the physicians treating uninsured patients. We examine whether uninsured and poor patients are treated by lower quality physicians with four measures of physician quality. Using a hospital fixed-effects model, we find that cardiac patients are matched to physician quality based on their ability to pay. Even after controlling for average physician quality within a hospital and patient characteristics, we find that uninsured and Medicaid patients are generally treated by lower quality physicians. We also find that while for-profit and not-for-profit hospitals treat the uninsured with lower quality physicians, government hospitals do not. However, there is evidence that hospitals of all ownership types treat Medicaid patients with lower quality physicians.

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File URL: http://home.fau.edu/svishwas/web/Physician%20Quality%20and%20Outcomes2.pdf
File Format: application/pdf
File Function: Revised version, 2007
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Publisher Info
Paper provided by Department of Economics, College of Business, Florida Atlantic University in its series Working Papers with number 06001.

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Length: 31 pages
Date of creation: Jul 2006
Date of revision:
Handle: RePEc:fal:wpaper:06001

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Related research
Keywords: Uninsured; Medicaid; Physician Quality; Hospital Ownership;

Find related papers by JEL classification:
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy

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References listed on IDEAS
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  1. Burns, Lawton R. & Wholey, Douglas R., 1992. "The impact of physician characteristics in conditional choice models for hospital care," Journal of Health Economics, Elsevier, vol. 11(1), pages 43-62, May. [Downloadable!] (restricted)
  2. Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December. [Downloadable!] (restricted)
  3. Frank Lichtenberg, 2002. "The Effects of Medicare on Health Care Utilization and Outcomes," Forum for Health Economics & Policy, Berkeley Electronic Press, vol. 5(1), pages 1028-1028. [Downloadable!] (restricted)
  4. Janet Currie & Jonathan Gruber, 1995. "Health Insurance Eligibility, Utilization of Medical care, and Child Health," NBER Working Papers 5052, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  5. Silverman, Elaine & Skinner, Jonathan, 2004. "Medicare upcoding and hospital ownership," Journal of Health Economics, Elsevier, vol. 23(2), pages 369-389, March. [Downloadable!] (restricted)
  6. Daniel P. Kessler & Mark B. McClellan, 2002. "The Effects of Hospital Ownership on Medical Productivity," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 488-506, Autumn.
  7. Busch, Susan H. & Duchovny, Noelia, 2005. "Family coverage expansions: Impact on insurance coverage and health care utilization of parents," Journal of Health Economics, Elsevier, vol. 24(5), pages 876-890, September. [Downloadable!] (restricted)
  8. Mehdi Farsi, 2004. "Changes in Hospital Quality after Conversion in Ownership Status," International Journal of Health Care Finance and Economics, Springer, vol. 4(3), pages 211-230, 09. [Downloadable!]
  9. Sloan, Frank A. & Picone, Gabriel A. & TaylorJr., Donald H. & Chou, Shin-Yi, 2001. "Hospital ownership and cost and quality of care: is there a dime's worth of difference?," Journal of Health Economics, Elsevier, vol. 20(1), pages 1-21, January. [Downloadable!] (restricted)
    Other versions:
  10. Propper, Carol & Burgess, Simon & Green, Katherine, 2004. "Does competition between hospitals improve the quality of care?: Hospital death rates and the NHS internal market," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1247-1272, July. [Downloadable!] (restricted)
  11. Richard G. Frank & David S. Salkever, 1991. "The Supply of Charity Services by Nonprofit Hospitals: Motives and Market Structure," RAND Journal of Economics, The RAND Corporation, vol. 22(3), pages 430-445, Autumn. [Downloadable!] (restricted)
  12. Edward C. Norton & Douglas O. Staiger, 1994. "How Hospital Ownership Affects Access to Care for the Uninsured," RAND Journal of Economics, The RAND Corporation, vol. 25(1), pages 171-185, Spring. [Downloadable!] (restricted)
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