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Does Where You Are Admitted Make a Difference? An Analysis of Medicare Data

In: Frontiers in Health Policy Research, volume 2

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  • Frank A. Sloan
  • Gabriel A. Picone
  • Donald H. Taylor, Jr.
  • Shin-Yi Chou

Abstract

This study investigated whether the type of hospital in which a Medicare beneficiary is admitted for hip fracture, stroke, coronary heart disease, or congestive heart failure matters in terms of amount and timing of Medicare payments and survival. In total, government hospitals were the least expensive for Medicare, with major teaching hospitals being most expensive within 6 months of admission after the index even. Survival was best in major teaching hospitals. When considering payments subsequent to those for the initial hospitalization, Medicare spent more for patients admitted to for-profit hospitals than for those admitted to other non-teaching facilities survival. Payments on behalf of patients treated in for-profit hospitals were higher for Medicare Part B and home health, especially during the first two months following discharge from the initial hospital. Results of our research suggest that Medicare has a definite financial interest in where Medicare beneficiaries are admitted for their hospital care.
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Suggested Citation

  • Frank A. Sloan & Gabriel A. Picone & Donald H. Taylor, Jr. & Shin-Yi Chou, 1999. "Does Where You Are Admitted Make a Difference? An Analysis of Medicare Data," NBER Chapters, in: Frontiers in Health Policy Research, volume 2, pages 1-26, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberch:9844
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    References listed on IDEAS

    as
    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. Sloan, Frank A. & Feldman, Roger D. & Steinwald, A. Bruce, 1983. "Effects of teaching on hospital costs," Journal of Health Economics, Elsevier, vol. 2(1), pages 1-28, March.
    3. Sloan, Frank A, et al, 1990. "The Demise of Hospital Philanthropy," Economic Inquiry, Western Economic Association International, vol. 28(4), pages 725-743, October.
    4. Edward C. Norton & Douglas O. Staiger, 1994. "How Hospital Ownership Affects Access to Care for the Uninsured," RAND Journal of Economics, The RAND Corporation, vol. 25(1), pages 171-185, Spring.
    5. Randall P. Ellis, 2012. "risk adjustment," The New Palgrave Dictionary of Economics,, Palgrave Macmillan.
    6. Manning, Willard G., 1998. "The logged dependent variable, heteroscedasticity, and the retransformation problem," Journal of Health Economics, Elsevier, vol. 17(3), pages 283-295, June.
    7. Becker, Edmund R & Sloan, Frank A, 1985. "Hospital Ownership and Performance," Economic Inquiry, Western Economic Association International, vol. 23(1), pages 21-36, January.
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    Cited by:

    1. Joseph J. Doyle Jr., 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," NBER Working Papers 11099, National Bureau of Economic Research, Inc.
    2. Gillian Currie & Cam Donaldson & Mingshan Lu, 2003. "What Does Canada Profit from the For-Profit Debate on Health Care?," Canadian Public Policy, University of Toronto Press, vol. 29(2), pages 227-251, June.
    3. Karen Eggleston & Yu‐Chu Shen & Joseph Lau & Christopher H. Schmid & Jia Chan, 2008. "Hospital ownership and quality of care: what explains the different results in the literature?," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1345-1362, December.
    4. Gauri, Varun, 2001. "Are incentives everything? payment mechanisms for health care providers in developing countries," Policy Research Working Paper Series 2624, The World Bank.
    5. Gabriel Picone & R. Mark Wilson & Shin‐Yi Chou, 2003. "Analysis of hospital length of stay and discharge destination using hazard functions with unmeasured heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 1021-1034, December.

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