IDEAS home Printed from https://ideas.repec.org/p/zbw/dicedp/208.html
   My bibliography  Save this paper

Higher prices, higher quality? Evidence from German nursing homes

Author

Listed:
  • Herr, Annika
  • Hottenrott, Hanna

Abstract

Objectives: This study investigates the relationship between prices and quality of 7,400 German nursing homes controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Method: We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, where we instrument prices to explain their effect on quality. Results: Descriptive analysis shows that prices and quality do not only vary across nursing homes, but also across counties and federal states and that quality and prices correlate positively. Second, the econometric analysis, which accounts for the endogenous relation between negotiated price and reported quality, shows that quality indeed positively depends on prices. In addition, more places in nursing homes per people in need are correlated with both lower prices and higher quality. Finally, unobserved factors at the federal state level explain some of the variation of reported quality across nursing homes. Conclusion: Our results suggest that higher prices increase quality. Furthermore, since reported quality and prices vary substantially across federal states, we conclude that the quality and prices of longtermcare facilities may well be compared within federal states but not across.

Suggested Citation

  • Herr, Annika & Hottenrott, Hanna, 2016. "Higher prices, higher quality? Evidence from German nursing homes," DICE Discussion Papers 208, Heinrich Heine University Düsseldorf, Düsseldorf Institute for Competition Economics (DICE).
    • Handle: RePEc:zbw:dicedp:208
    as

    Download full text from publisher

    File URL: https://www.econstor.eu/bitstream/10419/125801/1/845674129.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Arndt R. Reichert & Magdalena A. Stroka, 2018. "Nursing home prices and quality of care — Evidence from administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 129-140, January.
    2. Susan Feng Lu, 2012. "Multitasking, Information Disclosure, and Product Quality: Evidence from Nursing Homes," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 21(3), pages 673-705, September.
    3. Herr, Annika & Nguyen, Thu-Van & Schmitz, Hendrik, 2015. "Does quality disclosure improve quality? Responses to the introduction of nursing home report cards in Germany," DICE Discussion Papers 176, Heinrich Heine University Düsseldorf, Düsseldorf Institute for Competition Economics (DICE).
    4. David Dranove & Daniel Kessler & Mark McClellan & Mark Satterthwaite, 2003. "Is More Information Better? The Effects of "Report Cards" on Health Care Providers," Journal of Political Economy, University of Chicago Press, vol. 111(3), pages 555-588, June.
    5. 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.
    6. David C. Grabowski, 2001. "Does an Increase in the Medicaid Reimbursement Rate Improve Nursing Home Quality?," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 56(2), pages 84-93.
    7. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, December.
    8. 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.
    9. Roman Mennicken & Boris Augurzky & Heinz Rothgang & Jürgen Wasem, 2014. "Explaining differences in remuneration rates of nursing homes in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(4), pages 401-410, May.
    10. repec:zbw:rwirep:0470 is not listed on IDEAS
    11. Forder, Julien & Allan, Stephen, 2014. "The impact of competition on quality and prices in the English care homes market," Journal of Health Economics, Elsevier, vol. 34(C), pages 73-83.
    12. Dranove, David & Sfekas, Andrew, 2008. "Start spreading the news: A structural estimate of the effects of New York hospital report cards," Journal of Health Economics, Elsevier, vol. 27(5), pages 1201-1207, September.
    13. Andrews,Donald W. K. & Stock,James H. (ed.), 2005. "Identification and Inference for Econometric Models," Cambridge Books, Cambridge University Press, number 9780521844413.
    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. Arndt R. Reichert & Magdalena A. Stroka, 2018. "Nursing home prices and quality of care — Evidence from administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 129-140, January.
    2. Herr, A. & Saric, A., 2016. "The Welfare Effects of Single Rooms in German Nursing Homes: A Structural Approach," Health, Econometrics and Data Group (HEDG) Working Papers 16/23, HEDG, c/o Department of Economics, University of York.
    3. Rajendra Dulal, 2018. "Technical efficiency of nursing homes: do five-star quality ratings matter?," Health Care Management Science, Springer, vol. 21(3), pages 393-400, September.
    4. Anna Goeddeke & Justus Haucap & Annika Herr & Christian Wey, 2018. "Flexibility in Wage Setting Under the Threat of Relocation," LABOUR, CEIS, vol. 32(1), pages 1-22, March.
    5. Cristina Vilaplana-Prieto & Carmelo S. Gómez Martínez & Paloma Echevarría Pérez & Isabel Legaz, 2023. "Sociosanitary Legal and Economic Aspects in Nursing Homes for the Elderly in Spain," IJERPH, MDPI, vol. 20(6), pages 1-24, March.
    6. Céline Bonnet & Jan Philip Schain, 2020. "An Empirical Analysis Of Mergers: Efficiency Gains And Impact On Consumer Prices," Journal of Competition Law and Economics, Oxford University Press, vol. 16(1), pages 1-35.
    7. Herr, Annika & Nguyen, Thu-Van & Schmitz, Hendrik, 2016. "Public reporting and the quality of care of German nursing homes," Health Policy, Elsevier, vol. 120(10), pages 1162-1170.
    8. Cutler, Henry & Gu, Yuanyuan & Bilgrami, Anam & Partington, Andrew, 2023. "The 2021 proposal to increase market forces in the Australian residential aged-care sector," Health Policy, Elsevier, vol. 127(C), pages 60-65.
    9. Dörte Heger & Annika Herr & Anne Mensen, 2022. "Paying for the view? How nursing home prices affect certified staffing ratios," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1618-1632, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Herr, Annika & Nguyen, Thu-Van & Schmitz, Hendrik, 2016. "Public reporting and the quality of care of German nursing homes," Health Policy, Elsevier, vol. 120(10), pages 1162-1170.
    2. Herr, Annika & Nguyen, Thu-Van & Schmitz, Hendrik, 2015. "Does quality disclosure improve quality? Responses to the introduction of nursing home report cards in Germany," DICE Discussion Papers 176, Heinrich Heine University Düsseldorf, Düsseldorf Institute for Competition Economics (DICE).
    3. Haizhen Lin, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Working Papers 2014-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    4. Dörte Heger & Annika Herr & Anne Mensen, 2022. "Paying for the view? How nursing home prices affect certified staffing ratios," Health Economics, John Wiley & Sons, Ltd., vol. 31(8), pages 1618-1632, August.
    5. Zhao, Xin, 2016. "Competition, information, and quality: Evidence from nursing homes," Journal of Health Economics, Elsevier, vol. 49(C), pages 136-152.
    6. Arndt R. Reichert & Magdalena A. Stroka, 2018. "Nursing home prices and quality of care — Evidence from administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 129-140, January.
    7. Lin, Haizhen, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 37(C), pages 13-24.
    8. Herr, A. & Saric, A., 2016. "The Welfare Effects of Single Rooms in German Nursing Homes: A Structural Approach," Health, Econometrics and Data Group (HEDG) Working Papers 16/23, HEDG, c/o Department of Economics, University of York.
    9. repec:zbw:rwirep:0470 is not listed on IDEAS
    10. Foster, Andrew D. & Lee, Yong Suk, 2015. "Staffing subsidies and the quality of care in nursing homes," Journal of Health Economics, Elsevier, vol. 41(C), pages 133-147.
    11. Kathleen Carey & Shibei Zhao & A Lynn Snow & Christine W Hartmann, 2018. "The relationship between nursing home quality and costs: Evidence from the VA," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-9, September.
    12. Susan Feng Lu & Konstantinos Serfes & Gerard Wedig & Bingxiao Wu, 2021. "Does Competition Improve Service Quality? The Case of Nursing Homes Where Public and Private Payers Coexist," Management Science, INFORMS, vol. 67(10), pages 6493-6512, October.
    13. R. R. Croes & Y. J. F. M. Krabbe-Alkemade & M. C. Mikkers, 2018. "Competition and quality indicators in the health care sector: empirical evidence from the Dutch hospital sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(1), pages 5-19, January.
    14. Arndt R. Reicher & Magdalena Stroka, 2014. "Nursing Home Prices and Quality of Care - Evidence from Administrative Data," Ruhr Economic Papers 0470, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    15. Daifeng He & R. Tamara Konetzka, 2015. "Public Reporting and Demand Rationing: Evidence from the Nursing Home Industry," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1437-1451, November.
    16. Filistrucchi, L. & Ozbugday, F.C., 2012. "Mandatory Quality Disclosure and Quality Supply : Evidence from German Hospitals," Other publications TiSEM 680b0e3e-d3f5-4b91-9803-8, Tilburg University, School of Economics and Management.
    17. Dreher, Axel & Fuchs, Andreas & Langlotz, Sarah, 2019. "The effects of foreign aid on refugee flows," European Economic Review, Elsevier, vol. 112(C), pages 127-147.
    18. Joan Costa-Font & Sergi Jiménez-Martín & Cristina Vilaplana-Prieto, 2016. "Thinking of Incentivizing Care? The Effect of Demand Subsidies on Informal Caregiving and Intergenerational Transfers," Working Papers 2016-08, FEDEA.
    19. Olivella, Pau & Siciliani, Luigi, 2017. "Reputational concerns with altruistic providers," Journal of Health Economics, Elsevier, vol. 55(C), pages 1-13.
    20. Eichenauer, Vera Z. & Fuchs, Andreas & Brueckner, Lutz, 2018. "The Effects of Trade, Aid, and Investment on China's Image in Developing Countries," Working Papers 0646, University of Heidelberg, Department of Economics.
    21. Temple, Jonathan & Van de Sijpe, Nicolas, 2017. "Foreign aid and domestic absorption," Journal of International Economics, Elsevier, vol. 108(C), pages 431-443.

    More about this item

    Keywords

    nursing homes; care quality; price; long-term care; two-stage least squares;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L11 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Production, Pricing, and Market Structure; Size Distribution of Firms
    • L15 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Information and Product Quality
    • 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:zbw:dicedp:208. See general information about how to correct material in RePEc.

    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 bibliographic 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.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ZBW - Leibniz Information Centre for Economics (email available below). General contact details of provider: https://edirc.repec.org/data/diduede.html .

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

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.