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JUE Insight: Is hospital quality predictive of pandemic deaths? Evidence from US counties

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  • Kunz, Johannes S.
  • Propper, Carol

Abstract

In the large literature on the spatial-level correlates of COVID-19, the association between quality of hospital care and outcomes has received little attention to date. To examine whether county-level mortality is correlated with measures of hospital performance, we assess daily cumulative deaths and pre-crisis measures of hospital quality, accounting for state fixed-effects and potential confounders. As a measure of quality, we use the pre-pandemic adjusted five-year penalty rates for excess 30-day readmissions following pneumonia admissions for the hospitals accessible to county residents based on ambulance travel patterns. Our adjustment corrects for socio-economic status and down-weighs observations based on small samples. We find that a one-standard-deviation increase in the quality of local hospitals is associated with a 2% lower death rate (relative to the mean of 20 deaths per 10,000 people) one and a half years after the first recorded death.

Suggested Citation

  • Kunz, Johannes S. & Propper, Carol, 2023. "JUE Insight: Is hospital quality predictive of pandemic deaths? Evidence from US counties," Journal of Urban Economics, Elsevier, vol. 133(C).
  • Handle: RePEc:eee:juecon:v:133:y:2023:i:c:s0094119022000493
    DOI: 10.1016/j.jue.2022.103472
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    More about this item

    Keywords

    COVID-19; County-level deaths; Hospital quality; Health care systems;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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