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Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands

  • Varkevisser, Marco
  • van der Geest, Stéphanie A.
  • Schut, Frederik T.
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    A necessary condition for competition to promote quality in hospital markets is that patients are sensitive to differences in hospital quality. In this paper we examine the relationship between hospital quality, as measured by publicly available quality ratings, and patient hospital choice for angioplasty using individual claims data from a large health insurer. We find that Dutch patients have a high propensity to choose hospitals with a good reputation, both overall and for cardiology, and a low readmission rate after treatment for heart failure. Relative to a mean readmission rate of 8.5% we find that a 1%-point lower readmission rate is associated with a 12% increase in hospital demand. Since readmission rates are not adjusted for case-mix they may not provide a correct signal of hospital quality. Insofar patients base their hospital choice on such imperfect quality information, this may result in suboptimal choices and risk selection by hospitals.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0167629612000082
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    Article provided by Elsevier in its journal Journal of Health Economics.

    Volume (Year): 31 (2012)
    Issue (Month): 2 ()
    Pages: 371-378

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    Handle: RePEc:eee:jhecon:v:31:y:2012:i:2:p:371-378
    Contact details of provider: Web page: http://www.elsevier.com/locate/inca/505560

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    1. Tay, Abigail, 2003. " Assessing Competition in Hospital Care Markets: The Importance of Accounting for Quality Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 786-814, Winter.
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    8. Daniel McFadden & Kenneth Train, 2000. "Mixed MNL models for discrete response," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 15(5), pages 447-470.
    9. Epstein, Andrew J., 2010. "Effects of report cards on referral patterns to cardiac surgeons," Journal of Health Economics, Elsevier, vol. 29(5), pages 718-731, September.
    10. Howard David H, 2006. "Quality and Consumer Choice in Healthcare: Evidence from Kidney Transplantation," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 5(1), pages 1-22, January.
    11. Justin Wang & Jason Hockenberry & Shin-Yi Chou & Muzhe Yang, 2010. "Do Bad Report Cards Have Consequences? Impacts of Publicly Reported Provider Quality Information on the CABG Market in Pennsylvania," NBER Working Papers 16225, National Bureau of Economic Research, Inc.
    12. Bundorf, M. Kate & Chun, Natalie & Goda, Gopi Shah & Kessler, Daniel P., 2009. "Do markets respond to quality information? The case of fertility clinics," Journal of Health Economics, Elsevier, vol. 28(3), pages 718-727, May.
    13. Arne Risa Hole, 2007. "Modelling Heterogeneity in Patients' Preferences for the Attributes of a General Practitioner Appointment," Working Papers 022cherp, Centre for Health Economics, University of York.
    14. David Dranove & Daniel Kessler & Mark McClellan & Mark Satterthwaite, 2003. "Is More Information Better? The Effects of "Report Cards" on Health Care Providers," Journal of Political Economy, University of Chicago Press, vol. 111(3), pages 555-588, June.
    15. Glazer, Jacob & McGuire, Thomas G., 2006. "Optimal quality reporting in markets for health plans," Journal of Health Economics, Elsevier, vol. 25(2), pages 295-310, March.
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