Do Minimum Quality Standards Improve Quality? A Case Study of the Nursing Home Industry
This article estimates the impact of minimum staffing requirements on the nursing home market using a unique national panel over the 1996-2005 period. This study reveals that, given a half-hour increase in the minimum nursing hours per resident day for licensed nurses, quality of patient care increases by 25 percent. This quality-increasing effect is mainly driven by low-quality nursing homes increasing their quality of care to meet the new standards. By contrast, minimum staffing requirements for direct-care nurses do not have any significant impact on quality. This lack of impact may be explained by nursing home providers circumventing this regulation by hiring less expensive and less skilled laborers as substitutes for direct-care nurses.
|Date of creation:||Jan 2010|
|Date of revision:|
|Contact details of provider:|| Postal: 1309 East Tenth Street, Room 451, Bloomington, IN 47405-1701|
Web page: http://kelley.iu.edu/bepp/
More information through EDIRC
References listed on IDEAS
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.:
- Crampes, C. & Hollander, A., 1991.
"Duopoly and Quality Standards,"
Cahiers de recherche
9128, Centre interuniversitaire de recherche en économie quantitative, CIREQ.
- Nyman, John A., 1985. "Prospective and `cost-plus' medicaid reimbursement, excess medicaid demand, and the quality of nursing home care," Journal of Health Economics, Elsevier, vol. 4(3), pages 237-259, September.
- Chipty, Tasneem, 1995. "Economic Effects of Quality Regulations in the Day-Care Industry," American Economic Review, American Economic Association, vol. 85(2), pages 419-24, May.
- Gruber, J. & Hanratty, M., 1994.
"The Labor Market Efects of Introducing National Health Insurance: Evidence from Canada,"
94-05, Massachusetts Institute of Technology (MIT), Department of Economics.
- Gruber, Jonathan & Hanratty, Maria, 1995. "The Labor-Market Effects of Introducing National Health Insurance: Evidence from Canada," Journal of Business & Economic Statistics, American Statistical Association, vol. 13(2), pages 163-73, April.
- Jonathan Gruber & Maria Hanratty, 1993. "The Labor Market Effects of Introducing National Health Insurance: Evidence from Canada," NBER Working Papers 4589, National Bureau of Economic Research, Inc.
- William T. Gormley, 1991. "State regulations and the availability of child-care services," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 10(1), pages 78-95.
- Leora Friedberg, 1998. "Did Unilateral Divorce Raise Divorce Rates? Evidence from Panel Data," NBER Working Papers 6398, National Bureau of Economic Research, Inc.
- Naoto Jinji & Tsuyoshi Toshimitsu, 2004. "Minimum Quality Standards under Asymmetric Duopoly with Endogenous Quality Ordering: A Note," Journal of Regulatory Economics, Springer, vol. 26(2), pages 189-199, 09.
- David C. Grabowski, 2004. "A Longitudinal Study of Medicaid Payment, Private-Pay Price and Nursing Home Quality," International Journal of Health Care Finance and Economics, Springer, vol. 4(1), pages 5-26, 03.
- Valletti, Tommaso M, 2000. "Minimum Quality Standards under Cournot Competition," Journal of Regulatory Economics, Springer, vol. 18(3), pages 235-45, November.
- Gertler, Paul J., 1989. "Subsidies, quality, and the regulation of nursing homes," Journal of Public Economics, Elsevier, vol. 38(1), pages 33-52, February.
- V. Joseph Hotz & Mo Xiao, 2005. "The Impact of Minimum Quality Standards on Firm Entry, Exit and Product Quality: The Case of the Child Care Market," Working Papers 05-28, Center for Economic Studies, U.S. Census Bureau.
- Jeffrey R. Brown & Amy Finkelstein, 2009. "The Private Market for Long-Term Care Insurance in the United States: A Review of the Evidence," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 76(1), pages 5-29.
- Siebert, Ralph & von Graevenitz, Georg, 2006.
"How Licensing Resolves Hold-Up: Evidence from a Dynamic Panel Data Model with Unobserved Heterogeneity,"
CEPR Discussion Papers
5436, C.E.P.R. Discussion Papers.
- Siebert, Ralph & Graevenitz, Georg von, 2006. "How Licensing Resolves Hold-Up: Evidence from a Dynamic Panel Data Model with Unobserved Heterogeneity," Discussion Paper Series of SFB/TR 15 Governance and the Efficiency of Economic Systems 105, Free University of Berlin, Humboldt University of Berlin, University of Bonn, University of Mannheim, University of Munich.
- V. Joseph Hotz & Mo Xiao, 2005.
"The Impact of Regulations on the Supply and Quality of Care in Child Care Markets,"
NBER Working Papers
11873, National Bureau of Economic Research, Inc.
- V. Joseph Hotz & Mo Xiao, 2011. "The Impact of Regulations on the Supply and Quality of Care in Child Care Markets," American Economic Review, American Economic Association, vol. 101(5), pages 1775-1805, August.
- Wiggins, Steven N, 1981. "Product Quality Regulation and New Drug Introductions: Some New Evidence from the 1970s," The Review of Economics and Statistics, MIT Press, vol. 63(4), pages 615-19, November.
- Janet Currie & V. Joseph Hotz, 2002.
"Accidents Will Happen? Unintentional Childhood Injuries and the Effects of Child Care Regulations,"
JCPR Working Papers
268, Northwestern University/University of Chicago Joint Center for Poverty Research.
- Currie, Janet & Hotz, V. Joseph, 2004. "Accidents will happen?: Unintentional childhood injuries and the effects of child care regulations," Journal of Health Economics, Elsevier, vol. 23(1), pages 25-59, January.
- 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.
- Tom Doan, . "RATS program to replicate Arellano-Bond 1991 dynamic panel," Statistical Software Components RTZ00169, Boston College Department of Economics.
- Carl Shapiro, 1986. "Investment, Moral Hazard, and Occupational Licensing," Review of Economic Studies, Oxford University Press, vol. 53(5), pages 843-862.
- Cohen, Joel W. & Spector, William D., 1996. "The effect of Medicaid reimbursement on quality of care in nursing homes," Journal of Health Economics, Elsevier, vol. 15(1), pages 23-48, February.
- Kleiner, Morris M & Kudrle, Robert T, 2000. "Does Regulation Affect Economic Outcomes? The Case of Dentistry," Journal of Law and Economics, University of Chicago Press, vol. 43(2), pages 547-82, October.
- John A. Nyman, 1988. "Excess Demand, the Percentage of Medicaid Patients, and the Quality of Nursing Home Care," Journal of Human Resources, University of Wisconsin Press, vol. 23(1), pages 76-92.
- Grabowski, David C., 2001. "Medicaid reimbursement and the quality of nursing home care," Journal of Health Economics, Elsevier, vol. 20(4), pages 549-569, July.
When requesting a correction, please mention this item's handle: RePEc:iuk:wpaper:2010-01. 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: (Rick Harbaugh)
If references are entirely missing, you can add them using this form.