Public vs. Private Provision of Charity Care? Evidence from the Expiration of Hill-Burton Requirements in Florida
AbstractThis paper explores the consequences of the expiration of charity care requirements imposed on private hospitals by the Hill-Burton Act. We examine delivery care and the health of newborns using the universe of Florida births from 1989-2003 combined with hospital data from the American Hospital Association. We find that charity care requirements were binding on hospitals, but that private hospitals under obligation “cream skimmed” the least risky maternity patients. Conditional on patient characteristics, they provided less intensive maternity services but without compromising patient health. When obligations expired, private hospitals quickly reduced their charity caseloads, shifting maternity patients to public hospitals. There they received more intensive services, but did not experience improvements in health. These results suggest that public hospitals provided services less efficiently than private hospitals constrained to provide charity care.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 15798.
Date of creation: Mar 2010
Date of revision:
Publication status: published as Almond, Douglas, Janet Currie and Emilia Simeonova. "Public vs. Private Provision of Charity Care? Evidence from Hill-Burton Hospitals in Florida" Journal of Health Economics, Vol 30, Issue 1, pp 189-199, 2011.
Note: CH HC HE PE
Contact details of provider:
Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.
Web page: http://www.nber.org
More information through EDIRC
Other versions of this item:
- Almond, Douglas & Currie, Janet & Simeonova, Emilia, 2011. "Public vs. private provision of charity care? Evidence from the expiration of Hill-Burton requirements in Florida," Journal of Health Economics, Elsevier, Elsevier, vol. 30(1), pages 189-199, January.
- I1 - Health, Education, and Welfare - - Health
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
- I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Mark G. Duggan, 2000.
"Hospital Ownership And Public Medical Spending,"
The Quarterly Journal of Economics, MIT Press,
MIT Press, vol. 115(4), pages 1343-1373, November.
- Chernew, Michael & Keenan, Patricia & Cutler, David, 2005. "Charity Care, Risk Pooling, and the Decline in Private Health Insurance," Scholarly Articles 2640562, Harvard University Department of Economics.
- Janet Currie & Jonathan Gruber & Michael Fischer, 1994.
"Physician Payments and Infant Mortality: Evidence from Medicaid Fee Policy,"
NBER Working Papers
4930, National Bureau of Economic Research, Inc.
- Currie, Janet & Gruber, Jonathan & Fischer, Michael, 1995. "Physician Payments and Infant Mortality: Evidence from Medicaid Fee Policy," American Economic Review, American Economic Association, American Economic Association, vol. 85(2), pages 106-11, May.
- Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, Elsevier, vol. 18(4), pages 473-490, August.
- Sherry Glied & Joshua Zivin, 2000.
"How Do Doctors Behave When Some (But Not All) of Their Patients are in Managed Care?,"
NBER Working Papers
7907, National Bureau of Economic Research, Inc.
- Glied, Sherry & Zivin, Joshua Graff, 2002. "How do doctors behave when some (but not all) of their patients are in managed care?," Journal of Health Economics, Elsevier, Elsevier, vol. 21(2), pages 337-353, March.
- Michael Chernew & David Cutler & Patricia Seliger Keenan, 2005. "Charity Care, Risk Pooling, and the Decline in Private Health Insurance," American Economic Review, American Economic Association, American Economic Association, vol. 95(2), pages 209-213, May.
- 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.
- Rossin-Slater, Maya, 2013. "WIC in your neighborhood: New evidence on the impacts of geographic access to clinics," Journal of Public Economics, Elsevier, Elsevier, vol. 102(C), pages 51-69.
- Bacci, Silvia & Bartolucci, Francesco & Pieroni, Luca, 2012. "A causal analysis of motherâ€™s education on birth inequalities," MPRA Paper 38754, University Library of Munich, Germany.
- Hiroaki Matsuura, 2014. "Does the Constitutional Right to Health Matter? A Review of Current Evidence," CESifo DICE Report, Ifo Institute for Economic Research at the University of Munich, Ifo Institute for Economic Research at the University of Munich, vol. 12(2), pages 35-41, 07.
If references are entirely missing, you can add them using this form.