Estimating the out-of-hospital mortality rate using patient discharge data
This paper explores the hospital quality measures based on routine administrative data such as patient discharge records. Most of the measures used in the literature are based on in-hospital mortality risks rather than post-discharge events. The in-hospital outcomes are sensitive to the hospital's discharge policy, thus could bias the quality estimates. This study aims at identifying out-of-hospital mortality risks and disentangling discharge and re-hospitalization rates from mortality rates using patient discharge data. It is shown that these objectives can be achieved without post-discharge death records. This is an example of the use of public use administrative data for estimating empirical relations when key dependent variables are not available. Using data on the lengths of hospitalizations and out-of-hospital spells, the mortality rates before and after discharge are estimated for a sample of heart-attack patients hospitalized in California between 1992 and 1998. The results suggest that the quality assessments that ignore the variation of discharge rates among hospitals could be misleading. Copyright © 2006 John Wiley & Sons, Ltd.
Volume (Year): 15 (2006)
Issue (Month): 9 ()
|Contact details of provider:|| Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749|
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.:
- Tuma, Nancy Brandon & Robins, Philip K, 1980. "A Dynamic Model of Employment Behavior: An Application to the Seattle and Denver Income Maintenance Experiments," Econometrica, Econometric Society, vol. 48(4), pages 1031-52, May.
- Ho, Vivian & Hamilton, Barton H., 2000. "Hospital mergers and acquisitions: does market consolidation harm patients?," Journal of Health Economics, Elsevier, vol. 19(5), pages 767-791, September.
- John F. Geweke & Gautam Gowrisankaran & Robert J. Town, 2002.
"Bayesian inference for hospital quality in a selection model,"
Working Paper Series
2002-18, Federal Reserve Bank of San Francisco.
- John Geweke & Gautam Gowrisankaran & Robert J. Town, 2003. "Bayesian Inference for Hospital Quality in a Selection Model," Econometrica, Econometric Society, vol. 71(4), pages 1215-1238, 07.
- John Geweke & Gautam Gowrisankaran & Robert J. Town, 2001. "Bayesian Inference for Hospital Quality in a Selection Model," NBER Working Papers 8497, National Bureau of Economic Research, Inc.
- Kathleen Carey & James F. Burgess, 1999. "On measuring the hospital cost|quality trade-off," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 509-520.
- David M. Cutler, 1993.
"The Incidence of Adverse Medical Outcomes Under Prospective Payments,"
NBER Working Papers
4300, National Bureau of Economic Research, Inc.
- Cutler, David M, 1995. "The Incidence of Adverse Medical Outcomes under Prospective Payment," Econometrica, Econometric Society, vol. 63(1), pages 29-50, January.
- Cutler, D.M., 1992. "The Incidence of Adverse Medical Outcome Under Prospective Payment," Harvard Institute of Economic Research Working Papers 1603, Harvard - Institute of Economic Research.
- Burdett, Kenneth & Kiefer, Nicholas M. & Sharma, Sunil, 1985. "Layoffs and duration dependence in a model of turnover," Journal of Econometrics, Elsevier, vol. 28(1), pages 51-69, April.
- Mehdi Farsi, 2004. "Changes in Hospital Quality after Conversion in Ownership Status," International Journal of Health Care Finance and Economics, Springer, vol. 4(3), pages 211-230, 09.
- Chou, Shin-Yi, 2002. "Asymmetric information, ownership and quality of care: an empirical analysis of nursing homes," Journal of Health Economics, Elsevier, vol. 21(2), pages 293-311, March.
- Janet Currie & Mehdi Farsi & W. Bentley Macleod, 2005.
"Cut to the Bone? Hospital Takeovers and Nurse Employment Contracts,"
Cornell University, ILR School, vol. 58(3), pages 471-493, April.
- Janet Currie & Mehdi Farsi & W. Bentley MacLeod, 2003. "Cut to the Bone? Hospital Takeovers and Nurse Employment Contracts," NBER Working Papers 9428, National Bureau of Economic Research, Inc.
- Frank A. Sloan, 2002.
"Hospital Ownership Conversions: Defining the Appropriate Public Oversight Role,"
in: Frontiers in Health Policy Research, Volume 5, pages 123-166
National Bureau of Economic Research, Inc.
- Sloan Frank A., 2002. "Hospital Ownership Conversions: Defining the Appropriate Public Oversight Role," Forum for Health Economics & Policy, De Gruyter, vol. 5(1), pages 1-46, January.
- Sloan, Frank A., 2000. "Not-for-profit ownership and hospital behavior," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 21, pages 1141-1174 Elsevier.
- Mark B. McClellan & Douglas O. Staiger, 2000.
"Comparing Hospital Quality at For-Profit and Not- for-Profit Hospitals,"
in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 93-112
National Bureau of Economic Research, Inc.
- Mark McClellan & Douglas Staiger, 1999. "Comparing Hospital Quality at For-Profit and Not-for-Profit Hospitals," NBER Working Papers 7324, National Bureau of Economic Research, Inc.
- Gowrisankaran, Gautam & Town, Robert J., 1999. "Estimating the quality of care in hospitals using instrumental variables," Journal of Health Economics, Elsevier, vol. 18(6), pages 747-767, December.
When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:15:y:2006:i:9:p:983-995. 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: (Wiley-Blackwell Digital Licensing)or (Christopher F. Baum)
If references are entirely missing, you can add them using this form.