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The impact of HMO penetration on the relationship between nurse staffing and quality

Author

Listed:
  • Barbara A. Mark

    (School of Nursing, University of North Carolina at Chapel Hill, NC, USA)

  • David W. Harless

    (Department of Economics, Virginia Commonwealth University, Richmond, VA, USA)

  • Michael McCue

    (Department of Health Administration, Virginia Commonwealth University, Richmond, VA, USA)

Abstract

While there are a number of studies examining the relationship between nurse staffing and quality, none has examined structural differences in the relationship between nurse staffing and quality contingent upon the level of managed care penetration. We used administrative data, and a dynamic panel data model to examine this relationship in a panel of 422 acute care hospitals from 1990 to 1995. We found that there were significant differences in the relationship between nurse staffing and both mortality and length of stay depending upon the level of HMO penetration in the hospital's market. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • Barbara A. Mark & David W. Harless & Michael McCue, 2005. "The impact of HMO penetration on the relationship between nurse staffing and quality," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 737-753.
  • Handle: RePEc:wly:hlthec:v:14:y:2005:i:7:p:737-753
    DOI: 10.1002/hec.988
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    File URL: http://hdl.handle.net/10.1002/hec.988
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    References listed on IDEAS

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    1. Sloan, Frank A. & Picone, Gabriel A. & TaylorJr., Donald H. & Chou, Shin-Yi, 2001. "Hospital ownership and cost and quality of care: is there a dime's worth of difference?," Journal of Health Economics, Elsevier, vol. 20(1), pages 1-21, January.
    2. Mark B. McClellan & Douglas O. Staiger, 2000. "Comparing Hospital Quality at For-Profit and Not- for-Profit Hospitals," NBER Chapters,in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 93-112 National Bureau of Economic Research, Inc.
    3. Shen, Yu-Chu, 2003. "The effect of financial pressure on the quality of care in hospitals," Journal of Health Economics, Elsevier, vol. 22(2), pages 243-269, March.
    4. Michelle M. Mello & Sally C. Stearns & Edward C. Norton, 2002. "Do Medicare HMOs still reduce health services use after controlling for selection bias?," Health Economics, John Wiley & Sons, Ltd., vol. 11(4), pages 323-340.
    5. Manuel Arellano & Stephen Bond, 1991. "Some Tests of Specification for Panel Data: Monte Carlo Evidence and an Application to Employment Equations," Review of Economic Studies, Oxford University Press, vol. 58(2), pages 277-297.
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    Cited by:

    1. Hsueh-Fen Chen & Gloria Bazzoli & Hui-Min Hsieh, 2009. "Hospital Financial Conditions and the Provision of Unprofitable Services," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(3), pages 259-277, September.
    2. Yia-Wun Liang & Wen-Yi Chen & Yu-Hui Lin, 2015. "Estimating a Hospital Production Function to Evaluate the Effect of Nurse Staffing on Patient Mortality in Taiwan: The Longitudinal Count Data Approach," Journal for Economic Forecasting, Institute for Economic Forecasting, vol. 0(4), pages 154-169, December.

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