Abstract
AbstractPublic reporting on the quality of care is intended to guide patients to the provider with the highest quality and to stimulate a fair competition on quality. We apply a difference-in-differences design to test whether hospital quality has improved more in markets that are more competitive after the first public release of performance data in Germany in 2008. Panel data from 947 hospitals from 2006 to 2010 are used. Due to the high complexity of the treatment of stroke patients, we approximate general hospital quality by the 30-day risk-adjusted mortality rate for stroke treatment. Market structure is measured (comparatively) by the Herfindahl–Hirschman index (HHI) and by the number of hospitals in the relevant market. Predicted market shares based on exogenous variables only are used to compute the HHI to allow a causal interpretation of the reform effect. A homogenous positive effect of competition on quality of care is found. This effect is mainly driven by the response of non-profit hospitals that have a narrow range of services and private for-profit hospitals with a medium range of services. The results highlight the relevance of outcome transparency to enhance hospital quality competition.
Funder
Universitätsklinikum Schleswig-Holstein - Campus Lübeck
Publisher
Springer Science and Business Media LLC
Subject
Health Policy,Economics, Econometrics and Finance (miscellaneous)
Reference80 articles.
1. Street, A., Gutacker, N., Bojke, C., Devlin, N., Daidone, S.: Variations in outcome and costs among NHS providers for common surgical procedures: econometric analyses of routinely collected data. Health Services Deliv. Res. 2(1), 1–89 (2014)
2. Grieco, P.L., McDevitt, R.C.: Productivity and quality in health care: evidence from the dialysis industry. Rev. Econ. Stud. 84(3), 1071–1105 (2016)
3. Pauly, M.V.: The trade-off among quality, quantity, and cost: how to make it—if we must. Health Aff. (Millwood) 30(4), 574–580 (2011)
4. Ghaferi, A.A., Birkmeyer, J.D., Dimick, J.B.: Variation in hospital mortality associated with inpatient surgery. N. Engl. J. Med. 361(14), 1368–1375 (2009)
5. Ali, M., Salehnejad, R., Mansur, M.: Hospital heterogeneity: what drives the quality of health care. Eur. J. Health Econ. 19(3), 385–408 (2018)
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献