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Do Health Care Providers Quality Discriminate? Empirical Evidence from Primary Care Outpatient Clinics

  • Robert Rosenman

    ()

    (Washington State University)

  • Daniel Friesner

    (Gonzaga University)

  • Christopher Stevens

    (Ohio University, Eastern Campus)

There has been minimal attention paid to the mechanisms of hospital quality oversight that are currently in place. Accordingly this study will analyze the system of hospital quality regulation in the US. The Social Security Act as amended in 1965 gave the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) "deeming" power for Medicare quality requirements. There are numerous reasons why JCAHO's oversight strategy may be ineffective. The primary reason is the dual role of JCAHO as a regulator and advocate. In conclusion, JCAHO surveys do provide an incentive to hospitals to improve processes of care for the period leading up to an inspection and that incentive gets eliminated after the inspection occurs. JCAHO has announced a change from the scheduled survey to an unannounced strategy. The objective of this change is to provide an incentive to maintain a level of readiness. This may not occur if hospitals are motivated to minimize the overall cost of JCAHO compliance.

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File URL: http://college.holycross.edu/RePEc/eej/Archive/Volume31/V31N4P649_670.pdf
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Article provided by Eastern Economic Association in its journal Eastern Economic Journal.

Volume (Year): 31 (2005)
Issue (Month): 4 (Fall)
Pages: 649-670

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Handle: RePEc:eej:eeconj:v:31:y:2005:i:4:p:649-670
Contact details of provider: Postal: c/o Dr. Alexandre Olbrecht, The Anisfield School of Business 205, Ramapo College, 505 Ramapo Valley Road, Ramapo, New Jersey 07430, USA
Phone: (201) 684-7346
Web page: http://www.ramapo.edu/eea/journal.html
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  1. Friesner, Daniel L., 2003. "An empirical examination of cost-adjusting in outpatient clinics," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 31(6), pages 745-759.
  2. Mahmud Hassan & Gerard Wedig & Michael Morrisey, 2000. "Charity Care by Non-profit Hospitals: The Price of Tax-exempt Debt," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 7(1), pages 47-62.
  3. Dor, Avi & Farley, Dean E., 1996. "Payment source and the cost of hospital care: Evidence from a multiproduct cost function with multiple payers," Journal of Health Economics, Elsevier, vol. 15(1), pages 1-21, February.
  4. Gertler, Paul J, 1988. "A Latent-Variable Model of Quality Determination," Journal of Business & Economic Statistics, American Statistical Association, vol. 6(1), pages 97-104, January.
  5. Robert Rosenman & Tong Li & Dan Friesner, 2000. "Grants and cost shifting in outpatient clinics," Applied Economics, Taylor & Francis Journals, vol. 32(7), pages 835-843.
  6. Jack Zwanziger & Glenn A. Melnick & Anil Bamezai, 2000. "Can cost shifting continue in a price competitive environment?," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 211-226.
  7. Daniel Friesner & Robert Rosenman, 2001. "The Property Rights Theory of the Firm and Mixed Competition: A Counter-Example in the US Health Care Industry," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 8(3), pages 437-450.
  8. Gertler, Paul J & Waldman, Donald M, 1992. "Quality-Adjusted Cost Functions and Policy Evaluation in the Nursing Home Industry," Journal of Political Economy, University of Chicago Press, vol. 100(6), pages 1232-56, December.
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