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Hospital Ownership and Cost and Quality of Care: Is There a Dime's Worth of Difference?

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Author Info
Frank A. Sloan
Gabriel A. Picone
Donald H. Taylor, Jr.
Shin-Yi Chou

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Abstract

This paper compares cost and quality of care for Medicare patients hospitalized in for-profit hospitals contrasted with those in nonprofit and government hospitals following admission for hip fracture, stroke, coronary heart disease, or congestive heart failure. Cost of care in for-profit hospitals was similar to that of nonprofits, but patients admitted to government hospitals incurred less Medicare payments on average. There were only small differences in survival between for-profit, nonprofit, and government hospitals. Other measures of quality, including living in the community and activity of daily living limitations after index admission, show trivial differences by hospital ownership type. Between private sector hospital types (for-profit and nonprofit) there is indeed not a dime's worth of difference between the two in terms of cost to Medicare and patient outcome.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 6706.

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Date of creation: Aug 1998
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Handle: RePEc:nbr:nberwo:6706

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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.:
  1. Heckman, James & Singer, Burton, 1984. "A Method for Minimizing the Impact of Distributional Assumptions in Econometric Models for Duration Data," Econometrica, Econometric Society, vol. 52(2), pages 271-320, March. [Downloadable!] (restricted)
  2. William M. Emmons III & Robin A. Prager, 1997. "The Effects of Market Structure and Ownership on Prices and Service Offerings in the U.S. Cable Television Industry," RAND Journal of Economics, The RAND Corporation, vol. 28(4), pages 732-750, Winter. [Downloadable!] (restricted)
  3. Sloan, Frank A. & Feldman, Roger D. & Steinwald, A. Bruce, 1983. "Effects of teaching on hospital costs," Journal of Health Economics, Elsevier, vol. 2(1), pages 1-28, March. [Downloadable!] (restricted)
  4. Butler, J S & Anderson, Kathryn H & Burkhauser, Richard V, 1989. "Work and Health after Retirement: A Competing Risks Model with Semiparametric Unobserved Heterogeneity," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 46-53, February. [Downloadable!] (restricted)
  5. Boardman, Anthony E & Vining, Aidan R, 1989. "Ownership and Performance in Competitive Environments: A Comparison of the Performance of Private, Mixed, and State-Owned Enterprises," Journal of Law & Economics, University of Chicago Press, vol. 32(1), pages 1-33, April.
  6. John Vickers & George Yarrow, 1988. "Privatization: An Economic Analysis," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262720116.
  7. 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)
  8. Vining, Aidan R & Boardman, Anthony E, 1992. " Ownership versus Competition: Efficiency in Public Enterprise," Public Choice, Springer, vol. 73(2), pages 205-39, March.
  9. Jensen, Michael C & Murphy, Kevin J, 1990. "Performance Pay and Top-Management Incentives," Journal of Political Economy, University of Chicago Press, vol. 98(2), pages 225-64, April. [Downloadable!] (restricted)
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  10. Alan M. Garber & Victor R. Fuchs & James F. Silverman, 1984. "Case Mix, Costs, and Outcomes: Differences Between Faculty and Community Services in a University Hospital," NBER Working Papers 1159, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  11. 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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