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"Conventional outcomes report cardsƯ public disclosure of information about the patient-background-adjusted health outcomes of individual hospitals and physicians -- may help improve quality, but they may also encourage providers to "game" the system by avoiding sick and/or seeking healthy patients. In this paper, I propose an alternative approach: ranking hospitals on the basis of the travel distances of their Medicare patients. At least in theory, a distance report card could dominate conventional outcomes report cards: a distance report card might measure quality of care at least as well but suffer less from selection problems. I use data on elderly Medicare beneficiaries with heart attack and stroke from 1994 and 1999 to show that a distance report card would be both valid Ư that is, correlated with true quality Ư and able to distinguish confidently among hospitals Ư that is, able to reject at conventional significance levels the hypothesis that the true quality of a low-ranked hospital was the same as the quality of the average hospital. The hypothetical distance report card I propose compares favorably to (although does not necessarily dominate) the California AMI outcomes report card"--National Bureau of Economic Research web site.
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Subjects
Evaluation, Hospitals, Medicare, Patients, TransportationShowing 2 featured editions. View all 2 editions?
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Can ranking hospitals on the basis of patients' travel distances improve quality of care?
2005, National Bureau of Economic Research
in English
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Can ranking hospitals on the basis of patients' travel distances improve quality of care?
2005, National Bureau of Economic Research
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in English
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Book Details
Published in
Cambridge, Mass
Edition Notes
"June 2005."
Includes bibliographical references (p. 30).
Also available in PDF from the NBER world wide web site (www.nber.org).
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- Created September 29, 2008
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