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The Evolving Science of Quality Measurement for Hospitals: Implications for Studies of Competition and Consolidation

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  • Patrick S. Romano

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  • Ryan Mutter

    ()

Abstract

The literature on hospital competition and quality is young; most empirical studies have focused on few conditions and outcomes. Measures of in-hospital mortality and complications are susceptible to bias from unmeasured severity and transfer/discharge practices. Only one research team has evaluated related process and outcome measures, and none has exploited chart-review or patient survey-based data. Prior studies have generated inconsistent findings, suggesting the need for additional research. We describe the strengths and limitations of various approaches to quality measurement, summarize how quality has been operationalized in studies of hospital competition, outline three mechanisms by which competition may affect hospital quality, and propose measures appropriate for testing each mechanism.

Suggested Citation

  • Patrick S. Romano & Ryan Mutter, 2004. "The Evolving Science of Quality Measurement for Hospitals: Implications for Studies of Competition and Consolidation," International Journal of Health Economics and Management, Springer, vol. 4(2), pages 131-157, June.
  • Handle: RePEc:kap:ijhcfe:v:4:y:2004:i:2:p:131-157
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    Cited by:

    1. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    2. Herr, Annika (Ed.), 2013. "Beiträge zum Wettbewerb im Krankenhaus- und Arzneimittelmarkt - Band 1: Krankenhäuser," DICE Ordnungspolitische Perspektiven 37, University of Düsseldorf, Düsseldorf Institute for Competition Economics (DICE).
    3. Pflueger, Dane, 2016. "Knowing patients: The customer survey and the changing margins of accounting in healthcare," Accounting, Organizations and Society, Elsevier, vol. 53(C), pages 17-33.
    4. Carol Propper & Deborah Wilson, 2012. "The Use of Performance Measures in Health Care Systems," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 33 Edward Elgar Publishing.
    5. Giorgos Magoulios, 2005. "The Social Sector and Trans-Regional Collaboration Among Social Sector Institutions in Balkan Countries in Transition - A Case Study of Healthcare Institutions in Albania," South-Eastern Europe Journal of Economics, Association of Economic Universities of South and Eastern Europe and the Black Sea Region, vol. 3(2), pages 249-271.
    6. Chen, Chi-Chen & Cheng, Shou-Hsia, 2010. "Hospital competition and patient-perceived quality of care: Evidence from a single-payer system in Taiwan," Health Policy, Elsevier, vol. 98(1), pages 65-73, November.
    7. Herr, Annika, 2009. "Product differentiation and welfare in a mixed duopoly with regulated prices: the case of a public and a private hospital," FAU Discussion Papers in Economics 08/2009, Friedrich-Alexander University Erlangen-Nuremberg, Institute for Economics.
    8. Hsien-Ming Lien & Shin-Yi Chou & Jin-Tan Liu, 2010. "The Role Of Hospital Competition On Treatment Expenditure And Outcome: Evidence From Stroke And Cardiac Treatment In Taiwan," Economic Inquiry, Western Economic Association International, vol. 48(3), pages 668-689, July.
    9. José J. Escarce & Arvind K. Jain & Jeannette Rogowski, 2006. "Hospital Competition, Managed Care and Mortality After Hospitalization for Medical Conditions: Evidence From Three States," NBER Working Papers 12335, National Bureau of Economic Research, Inc.
    10. Moscone, Francesco & Tosetti, Elisa & Vittadini, Giorgio, 2009. "Social Interaction in Patients'�Hospital Choice: Evidences from Italy," MPRA Paper 17783, University Library of Munich, Germany.
    11. repec:kap:hcarem:v:20:y:2017:i:2:d:10.1007_s10729-015-9348-9 is not listed on IDEAS

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