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Mitigating the Problem of Unmeasured Outcomes in Quality Reports

Author

Listed:
  • Glazer Jacob

    (Tel Aviv University & Boston University)

  • McGuire Thomas

    (Harvard Medical School)

  • Normand Sharon-Lise T.

    (Harvard Medical School & Harvard School of Public Health)

Abstract

Quality reports or profiles of health care providers are inevitably based on only a measurable subset of the ``outputs" of the organization. Hospitals, for example, are being profiled on their mortality in the cardiac area but not in some other areas where mortality does not seem to be the appropriate measure of quality. If inputs used for outputs included in the profile also affect outputs outside the scope of the profile, it can be taken into account in constructing a profile of the measured outputs. This paper presents a theory for how such a commonality in production should be taken into account in designing a profile for a hospital or other health care provider. We distinguish between ``conventional" weights in a quality profile, and ``optimal" weights that take into account a commonality in the production process. The basic idea is to increase the weights on discharges for which output is measured that use inputs that are important to other discharges whose outputs are not included in the profile.

Suggested Citation

  • Glazer Jacob & McGuire Thomas & Normand Sharon-Lise T., 2008. "Mitigating the Problem of Unmeasured Outcomes in Quality Reports," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 8(2), pages 1-18, July.
    • Handle: RePEc:bpj:bejeap:v:8:y:2008:i:2:n:7
    DOI: 10.2202/1935-1682.1738
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    References listed on IDEAS

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    1. Canice Prendergast, 1999. "The Provision of Incentives in Firms," Journal of Economic Literature, American Economic Association, vol. 37(1), pages 7-63, March.
    2. Glazer, Jacob & McGuire, Thomas G., 2006. "Optimal quality reporting in markets for health plans," Journal of Health Economics, Elsevier, vol. 25(2), pages 295-310, March.
    3. Holmstrom, Bengt & Milgrom, Paul, 1991. "Multitask Principal-Agent Analyses: Incentive Contracts, Asset Ownership, and Job Design," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 7(0), pages 24-52, Special I.
    4. Glied, Sherry & Zivin, Joshua Graff, 2002. "How do doctors behave when some (but not all) of their patients are in managed care?," Journal of Health Economics, Elsevier, vol. 21(2), pages 337-353, March.
    5. Diamond, Peter A & Mirrlees, James A, 1971. "Optimal Taxation and Public Production II: Tax Rules," American Economic Review, American Economic Association, vol. 61(3), pages 261-278, June.
    6. Diamond, Peter A & Mirrlees, James A, 1971. "Optimal Taxation and Public Production: I--Production Efficiency," American Economic Review, American Economic Association, vol. 61(1), pages 8-27, March.
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    Cited by:

    1. Ching‐to Albert Ma & Henry Y. Mak, 2014. "Public Report, Price, and Quality," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 23(2), pages 443-464, June.
    2. Tisamarie B. Sherry, 2016. "A Note on the Comparative Statics of Pay‐for‐Performance in Health Care," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 637-644, May.
    3. Tisamarie B. Sherry & Sebastian Bauhoff & Manoj Mohanan, 2017. "Multitasking and Heterogeneous Treatment Effects in Pay-for-Performance in Health Care: Evidence from Rwanda," American Journal of Health Economics, MIT Press, vol. 3(2), pages 192-226, Spring.
    4. Suh Jeongmeen, 2012. "A Theory of Optimal Quality Reports with Inertia," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 12(1), pages 1-28, December.

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