Can ranking hospitals on the basis of patients' travel distances improve quality of care?
By: Daniel P. Kessler.
Contributors: National Bureau of Economic Research.
Series: NBER working paper series ;; working paper 11419; Working paper series (National Bureau of Economic Research : Online) ;; working paper no. 11419.
Publisher: National Bureau of Economic Research
Published: 2005
Place of publication: Cambridge, MA
Language: eng
Format: Electronic resource
Subjects: Hospitals -- Evaluation.; Medicare.; Patients.; Transportation.
Description: "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.
Notes: Also available in print.
Includes bibliographical references.
Title from PDF file as viewed on 7/11/2005.
System requirements: Adobe Acrobat Reader.
Mode of access: World Wide Web.