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Comparing the Quality of Health Care Providers

Author

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  • McClellan Mark

    (Stanford University and NBER)

  • Staiger Douglas

    (Dartmouth College and NBER)

Abstract

This article introduces a new approach for evaluating the quality of healthcare providers, including an integrated solution to several problems that limit the usefulness of available methods. Our approach combines information from all the quality indicators available for a provider (e.g., from other years, other patients, or other indicators for the same patients) to estimate more accurately the provider's previous or expected quality. The approach also provides an empirical basis for comparing and combining alternative quality indicators, thereby enabling policy makers to choose among potential indicators, explore the potential bias in alternative measures, and increase the value of quality measures for assessing and improving care. Using hospital care for elderly heart attack patients as an example, we demonstrate that these methods can be used to create reliable, precise predictions about provider quality. Comparing quality of care across providers may be far more feasible than many now believe.

Suggested Citation

  • McClellan Mark & Staiger Douglas, 2000. "Comparing the Quality of Health Care Providers," Forum for Health Economics & Policy, De Gruyter, vol. 3(1), pages 1-26, January.
    • Handle: RePEc:bpj:fhecpo:v:3:y:2000:n:6
    DOI: 10.2202/1558-9544.1019
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    References listed on IDEAS

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    1. 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 Not-for-Profit and For-Profit Institutions, pages 93-112, National Bureau of Economic Research, Inc.
    2. David Dranove & Mark A. Satterthwaite, 1992. "Monopolistic Competition When Price and Quality are Imperfectly Observable," RAND Journal of Economics, The RAND Corporation, vol. 23(4), pages 518-534, Winter.
    3. Mark McClellan & Douglas Staiger, 1999. "The Quality of Health Care Providers," NBER Working Papers 7327, National Bureau of Economic Research, Inc.
    4. David M. Cutler, 2000. "The Changing Hospital Industry: Comparing Not-for-Profit and For-Profit Institutions," NBER Books, National Bureau of Economic Research, Inc, number cutl00-1, March.
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    Cited by:

    1. Carol Propper & John Van Reenen, 2010. "Can Pay Regulation Kill? Panel Data Evidence on the Effect of Labor Markets on Hospital Performance," Journal of Political Economy, University of Chicago Press, vol. 118(2), pages 222-273, April.
    2. Cunha, Jesse M. & Miller, Trey, 2014. "Measuring value-added in higher education: Possibilities and limitations in the use of administrative data," Economics of Education Review, Elsevier, vol. 42(C), pages 64-77.
    3. Herr, Annika (Ed.), 2013. "Beiträge zum Wettbewerb im Krankenhaus- und Arzneimittelmarkt - Band 1: Krankenhäuser," DICE Ordnungspolitische Perspektiven 37, Heinrich Heine University Düsseldorf, Düsseldorf Institute for Competition Economics (DICE).
    4. Carine Milcent, 2005. "Hospital ownership, reimbursement systems and mortality rates," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1151-1168, November.
    5. Cook, Andrew & Gaynor, Martin & Stephens Jr, Melvin & Taylor, Lowell, 2012. "The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California's minimum staffing regulation," Journal of Health Economics, Elsevier, vol. 31(2), pages 340-348.
    6. Tom Stargardt & Jonas Schreyögg & Ivan Kondofersky, 2014. "Measuring The Relationship Between Costs And Outcomes: The Example Of Acute Myocardial Infarction In German Hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 23(6), pages 653-669, June.
    7. Laudicella, Mauro & Li Donni, Paolo & Smith, Peter C., 2013. "Hospital readmission rates: Signal of failure or success?," Journal of Health Economics, Elsevier, vol. 32(5), pages 909-921.
    8. Pääkkönen, Jenni & Seppälä, Timo, 2012. "Dimensions of health care system quality in Finland," Working Papers 31, VATT Institute for Economic Research.
    9. Amitabh Chandra & Jonathan Skinner, 2003. "Geography and Racial Health Disparities," NBER Working Papers 9513, National Bureau of Economic Research, Inc.
    10. Moffett, Maurice L. & Morgan, Robert O. & Ashton, Carol M., 2005. "Strategic opportunities in the oversight of the U.S. hospital accreditation system," Health Policy, Elsevier, vol. 75(1), pages 109-115, December.

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