Managed care and measuring medical outcomes: Did the rise of HMOs contribute to the fall in the autopsy rate?
The U.S. autopsy rate has fallen precipitously since the 1940s, decreasing from 50 percent of bodies to less than eight percent today. Much of the decrease occurred after 1971 when hospitals were no longer required to do a minimum number of autopsies for accreditation. Since this time, major changes in the health care sector have occurred in the United States, highlighted by the increased importance of managed care. Using data for 46 states from 1987 to 2000, we analyze the degree to which the rise in manage care explains the decrease in the autopsy rate. We find that increases in health maintenance organization market share explain 21 percent of the decrease in the autopsy rate over the years from 1987 to 2000 and reductions in the number of hospital deaths explain another 30 percent. In contrast, we find that increases in the availability of magnetic resonance imaging had no significant effect on autopsy rates when other factors are held constant. Reforming health care financing to restrain the growth in health care costs using incentive mechanisms similar to those employed by managed care organizations has been a recurring policy goal in the United States. Our results imply that these reforms may inadvertently reduce the incentive to monitor medical outcomes using techniques such as autopsies, which is often called the "gold standard" in measuring medical outcomes.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 70 (2010)
Issue (Month): 2 (January)
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
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.:
- Mello, Michelle M. & Hemenway, David, 2004. "Medical malpractice as an epidemiological problem," Social Science & Medicine, Elsevier, vol. 59(1), pages 39-46, July.
- Laurence Baker, 2000. "What Does HMO Market Share Measure? Examining Provider Choice Restrictions," NBER Chapters, in: Frontiers in Health Policy Research, Volume 3, pages 91-112 National Bureau of Economic Research, Inc.
- Town, Robert & Vistnes, Gregory, 2001. "Hospital competition in HMO networks," Journal of Health Economics, Elsevier, vol. 20(5), pages 733-753, September.
- Baker Laurence, 2000. "What Does HMO Market Share Measure? Examining Provider Choice Restrictions," Forum for Health Economics & Policy, De Gruyter, vol. 3(1), pages 1-24, January.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:70:y:2010:i:2:p:191-198. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.