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Government Regulation and the Quality of Healthcare: Evidence from Minimum Staffing Legislation for Nursing Homes

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  • Jordan D. Matsudaira

Abstract

This paper investigates the effect of a regulation mandating a minimum nurse-staffing level on the quality of healthcare in nursing homes. To comply with the regulation, firms increase employment of nurses in proportion to the gap between their initial staffing level and the legislated minimum threshold. If higher nurse staffing causes better quality, then the changes in quality outcomes should mirror these changes. Despite inducing increases in nurse aide hours of 10 percent on average and up to 30 percent for some firms, I find no impact of the regulation on patient outcomes or overall facility quality.

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  • Jordan D. Matsudaira, 2014. "Government Regulation and the Quality of Healthcare: Evidence from Minimum Staffing Legislation for Nursing Homes," Journal of Human Resources, University of Wisconsin Press, vol. 49(1), pages 32-72.
  • Handle: RePEc:uwp:jhriss:v:49:y:2014:i:1:p:32-72
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    References listed on IDEAS

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    1. Charlene Harrington & David Zimmerman & Sarita L. Karon & James Robinson & Patricia Beutel, 2000. "Nursing Home Staffing and Its Relationship to Deficiencies," Journals of Gerontology: Series B, Gerontological Society of America, vol. 55(5), pages 278-287.
    2. Leland, Hayne E, 1979. "Quacks, Lemons, and Licensing: A Theory of Minimum Quality Standards," Journal of Political Economy, University of Chicago Press, vol. 87(6), pages 1328-1346, December.
    3. Janet Currie & Mehdi Farsi & W. Bentley Macleod, 2005. "Cut to the Bone? Hospital Takeovers and Nurse Employment Contracts," ILR Review, Cornell University, ILR School, vol. 58(3), pages 471-493, April.
    4. Cawley, John & Grabowski, David C. & Hirth, Richard A., 2006. "Factor substitution in nursing homes," Journal of Health Economics, Elsevier, vol. 25(2), pages 234-247, March.
    5. Evans, William N. & Kim, Beomsoo, 2006. "Patient outcomes when hospitals experience a surge in admissions," Journal of Health Economics, Elsevier, vol. 25(2), pages 365-388, March.
    6. George A. Akerlof, 1970. "The Market for "Lemons": Quality Uncertainty and the Market Mechanism," The Quarterly Journal of Economics, Oxford University Press, vol. 84(3), pages 488-500.
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    Citations

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    Cited by:

    1. John R. Bowblis & Andrew Ghattas, 2017. "The Impact of Minimum Quality Standard Regulations on Nursing Home Staffing, Quality, and Exit Decisions," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 50(1), pages 43-68, February.
    2. repec:eee:hapoch:v1_951 is not listed on IDEAS
    3. Haizhen Lin, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Working Papers 2014-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    4. Lin, Haizhen, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 37(C), pages 13-24.
    5. repec:tpr:amjhec:v:4:y:2018:i:2:p:131-163 is not listed on IDEAS
    6. Yaa Akosa Antwi & John R. Bowblis, 2018. "The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession," American Journal of Health Economics, MIT Press, vol. 4(2), pages 131-163, Spring.

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