IDEAS home Printed from https://ideas.repec.org/p/auu/dpaper/657.html
   My bibliography  Save this paper

Do Health Care Report Cards Cause Providers to Select Patients and Raise Quality of Care?

Author

Listed:
  • Yijuan Chen
  • Juergen Meinecke

Abstract

We exploit a brief period of asymmetric information during the implementation of Pennsylvania’s “report card” scheme for coronary artery bypass graft surgery to test for improvements in quality of care and selection of patients by health care providers. During the ?rst three years of the 1990s, providers in Pennsylvania had an incentive to bias report cards by selecting patients strategically, with patients having no access to the report cards. This dichotomy enables us to separate providers’ selection of patients from patients’ selection of providers. Using data from the Nationwide Inpatient Sample, we estimate a non–linear difference–in– differences model and derive asymptotic standard errors. The mortality rate for bypass patients decreases by only 0.05 percentage points due to the report cards, which we interpret as evidence that quality of bypass surgery did not improve (at least in the short–term) nor did patient selection by providers occur. Our timing, estimation, and asymptotics are readily applicable to many other report card schemes.

Suggested Citation

  • Yijuan Chen & Juergen Meinecke, 2012. "Do Health Care Report Cards Cause Providers to Select Patients and Raise Quality of Care?," CEPR Discussion Papers 657, Centre for Economic Policy Research, Research School of Economics, Australian National University.
  • Handle: RePEc:auu:dpaper:657
    as

    Download full text from publisher

    File URL: https://www.cbe.anu.edu.au/researchpapers/cepr/DP657.pdf
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    as
    1. Hansen, Christian B., 2007. "Asymptotic properties of a robust variance matrix estimator for panel data when T is large," Journal of Econometrics, Elsevier, vol. 141(2), pages 597-620, December.
    2. Hansen, Christian B., 2007. "Generalized least squares inference in panel and multilevel models with serial correlation and fixed effects," Journal of Econometrics, Elsevier, vol. 140(2), pages 670-694, October.
    3. Chen, Yijuan, 2011. "Why are health care report cards so bad (good)?," Journal of Health Economics, Elsevier, vol. 30(3), pages 575-590, May.
    4. Gaskin, Darrell J., 1997. "Altruism or moral hazard: The impact of hospital uncompensated care pools," Journal of Health Economics, Elsevier, vol. 16(4), pages 397-416, August.
    5. Papke, Leslie E. & Wooldridge, Jeffrey M., 2008. "Panel data methods for fractional response variables with an application to test pass rates," Journal of Econometrics, Elsevier, vol. 145(1-2), pages 121-133, July.
    6. Gravelle, Hugh & Sivey, Peter, 2010. "Imperfect information in a quality-competitive hospital market," Journal of Health Economics, Elsevier, vol. 29(4), pages 524-535, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Chou, Shin-Yi & Deily, Mary E. & Li, Suhui & Lu, Yi, 2014. "Competition and the impact of online hospital report cards," Journal of Health Economics, Elsevier, vol. 34(C), pages 42-58.

    More about this item

    Keywords

    health care report cards; provider moral hazard; quality improvement; difference–in–differences estimation;

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:auu:dpaper:657. 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: (). General contact details of provider: http://edirc.repec.org/data/cpanuau.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.