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Estimating the Out-of-Hospital Mortality Rate Using Patient Discharge Data

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Author Info
Mehdi Farsi
Geert Ridder

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Abstract

This paper is a case study of the use of public use administrative data for the estimation of empirical relations when key dependent variables are not available in the data. It is shown that the out-of-hospital mortality rates can be identified using the patient discharge data without post-discharge death records. Using data on the lengths of hospitalizations and out-of-hospital spells, the mortality rates before and after discharge as well as discharge and re-hospitalization rates are estimated for a sample of heart-attack patients hospitalized in California between 1992 and 1998. The results suggest that ignoring variation of discharge rates among hospital types could be misleading in evaluating hospital performance regarding mortality risks.

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File URL: http://www.usc.edu/dept/LAS/economics/IEPR/Working%20Papers/IEPR_06.45_%5BFarsi,Ridder%5D.pdf
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File Function: First version, 2006
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Publisher Info
Paper provided by Institute of Economic Policy Research (IEPR) in its series IEPR Working Papers with number 06.45.

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Length: 28 pages
Date of creation: Mar 2006
Date of revision:
Handle: RePEc:scp:wpaper:06-45

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Related research
Keywords: Mortality; Hospital quality; Duration models; Survival analysis;

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This paper has been announced in the following NEP Reports: References listed on IDEAS
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. Gowrisankaran, Gautam & Town, Robert J., 1999. "Estimating the quality of care in hospitals using instrumental variables," Journal of Health Economics, Elsevier, vol. 18(6), pages 747-767, December. [Downloadable!] (restricted)
  2. Janet Currie & Mehdi Farsi & W. Bentley MacLeod, 2003. "Cut to the Bone? Hospital Takeovers and Nurse Employment Contracts," NBER Working Papers 9428, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  3. Burdett, Kenneth & Kiefer, Nicholas M. & Sharma, Sunil, 1985. "Layoffs and duration dependence in a model of turnover," Journal of Econometrics, Elsevier, vol. 28(1), pages 51-69, April. [Downloadable!] (restricted)
  4. Frank A. Sloan, 2002. "Hospital Ownership Conversions: Defining the Appropriate Public Oversight Role," Forum for Health Economics & Policy, Berkeley Electronic Press, vol. 5. [Downloadable!]
  5. Frank A. Sloan, 2002. "Hospital Ownership Conversions: Defining the Appropriate Public Oversight Role," NBER Chapters, in: Frontiers in Health Policy Research, Volume 5, pages 123-166 National Bureau of Economic Research, Inc. [Downloadable!]
  6. Shen, Yu-Chu, 2002. "The effect of hospital ownership choice on patient outcomes after treatment for acute myocardial infarction," Journal of Health Economics, Elsevier, vol. 21(5), pages 901-922, September. [Downloadable!] (restricted)
  7. 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.
  8. Cutler, David M, 1995. "The Incidence of Adverse Medical Outcomes under Prospective Payment," Econometrica, Econometric Society, vol. 63(1), pages 29-50, January. [Downloadable!] (restricted)
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  9. 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!]
  10. John Geweke & Gautam Gowrisankaran & Robert J. Town, 2003. "Bayesian Inference for Hospital Quality in a Selection Model," Econometrica, Econometric Society, vol. 71(4), pages 1215-1238, 07. [Downloadable!] (restricted)
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  11. Mark B. McClellan & Douglas O. Staiger, 2000. "Comparing Hospital Quality at For-Profit and Not- for-Profit Hospitals," NBER Chapters, in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 93-112 National Bureau of Economic Research, Inc. [Downloadable!]
  12. Kathleen Carey & James F. Burgess, 1999. "On measuring the hospital cost|quality trade-off," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 509-520.
  13. Sloan, Frank A., 2000. "Not-for-profit ownership and hospital behavior," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 21, pages 1141-1174 Elsevier. [Downloadable!] (restricted)
  14. Tuma, Nancy Brandon & Robins, Philip K, 1980. "A Dynamic Model of Employment Behavior: An Application to the Seattle and Denver Income Maintenance Experiments," Econometrica, Econometric Society, vol. 48(4), pages 1031-52, May. [Downloadable!] (restricted)
  15. Ho, Vivian & Hamilton, Barton H., 2000. "Hospital mergers and acquisitions: does market consolidation harm patients?," Journal of Health Economics, Elsevier, vol. 19(5), pages 767-791, September. [Downloadable!] (restricted)
  16. Carine Milcent, 2003. "Ownership, System of reimbursement and Mortality rate relationships," DELTA Working Papers 2003-18, DELTA (Ecole normale supérieure). [Downloadable!]
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(explanations, 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. Paul H. Jensen & Elizabeth Webster & Julia Witt, 2007. "Hospital Type and Patient Outcomes: An Empirical Examination Using AMI Re-admission and Mortality Records," Melbourne Institute Working Paper Series wp2007n31, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne. [Downloadable!]
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