IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v68y2019ics0167629618307495.html
   My bibliography  Save this article

Subjective and objective quality and choice of hospital: Evidence from maternal care services in Germany

Author

Listed:
  • Avdic, Daniel
  • Moscelli, Giuseppe
  • Pilny, Adam
  • Sriubaite, Ieva

Abstract

We study patient choice of healthcare provider based on both objective and subjective quality measures in the context of maternal care hospital services in Germany. Objective measures are obtained from publicly reported clinical indicators, while subjective measures are based on satisfaction scores from a large and nationwide patient survey. We merge both quality metrics to detailed hospital discharge records and quantify the additional distance expectant mothers are willing to travel to give birth in maternity clinics with higher reported quality. Our results reveal that patients are on average willing to travel 0.1–2.7 additional kilometers for a one standard deviation increase in quality. Patients respond to both objective and subjective quality measures, suggesting that patient satisfaction scores may constitute important complements to clinical indicators when choosing provider.

Suggested Citation

  • Avdic, Daniel & Moscelli, Giuseppe & Pilny, Adam & Sriubaite, Ieva, 2019. "Subjective and objective quality and choice of hospital: Evidence from maternal care services in Germany," Journal of Health Economics, Elsevier, vol. 68(C).
    • Handle: RePEc:eee:jhecon:v:68:y:2019:i:c:s0167629618307495
    DOI: 10.1016/j.jhealeco.2019.102229
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629618307495
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jhealeco.2019.102229?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Alexander Karmann & Felix Roesel, 2017. "Hospital Policy and Productivity – Evidence from German States," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1548-1565, December.
    2. David M. Cutler & Robert S. Huckman & Mary Beth Landrum, 2004. "The Role of Information in Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Surgery," American Economic Review, American Economic Association, vol. 94(2), pages 342-346, May.
    3. Kurt R. Brekke & Hugh Gravelle & Luigi Siciliani & Odd Rune Straume, 2014. "Patient Choice, Mobility and Competition Among Health Care Providers," Developments in Health Economics and Public Policy, in: Rosella Levaggi & Marcello Montefiori (ed.), Health Care Provision and Patient Mobility, edition 127, pages 1-26, Springer.
    4. Walter Beckert & Mette Christensen & Kate Collyer, 2012. "Choice of NHS‐funded Hospital Services in England," Economic Journal, Royal Economic Society, vol. 122(560), pages 400-417, May.
    5. Stephan Huber & Christoph Rust, 2016. "Calculate travel time and distance with OpenStreetMap data using the Open Source Routing Machine (OSRM)," Stata Journal, StataCorp LP, vol. 16(2), pages 416-423, June.
    6. Bundorf, M. Kate & Chun, Natalie & Goda, Gopi Shah & Kessler, Daniel P., 2009. "Do markets respond to quality information? The case of fertility clinics," Journal of Health Economics, Elsevier, vol. 28(3), pages 718-727, May.
    7. Giuseppe Moscelli & Luigi Siciliani & Nils Gutacker & Hugh Gravelle, 2016. "Location, quality and choice of hospital: Evidence from England 2002/3 - 2012/13," Working Papers 123cherp, Centre for Health Economics, University of York.
    8. Jin, Ginger Zhe & Sorensen, Alan T., 2006. "Information and consumer choice: The value of publicized health plan ratings," Journal of Health Economics, Elsevier, vol. 25(2), pages 248-275, March.
    9. Wedig, Gerard J. & Tai-Seale, Ming, 2002. "The effect of report cards on consumer choice in the health insurance market," Journal of Health Economics, Elsevier, vol. 21(6), pages 1031-1048, November.
    10. Adam Pilny, 2017. "Explaining Differentials in Subsidy Levels Among Hospital Ownership Types in Germany," Health Economics, John Wiley & Sons, Ltd., vol. 26(5), pages 566-581, May.
    11. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 82(2), pages 457-489.
    12. Tay, Abigail, 2003. "Assessing Competition in Hospital Care Markets: The Importance of Accounting for Quality Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 786-814, Winter.
    13. Peter Sivey, 2012. "The effect of waiting time and distance on hospital choice for English cataract patients," Health Economics, John Wiley & Sons, Ltd., vol. 21(4), pages 444-456, April.
    14. Pilny, Adam & Wübker, Ansgar & Ziebarth, Nicolas R., 2017. "Introducing risk adjustment and free health plan choice in employer-based health insurance: Evidence from Germany," Journal of Health Economics, Elsevier, vol. 56(C), pages 330-351.
    15. Moscelli, Giuseppe & Siciliani, Luigi & Gutacker, Nils & Gravelle, Hugh, 2016. "Location, quality and choice of hospital: Evidence from England 2002–2013," Regional Science and Urban Economics, Elsevier, vol. 60(C), pages 112-124.
    16. Martin Gaynor, "undated". "What Do We Know About Competition and Quality in Health Care Markets?," GSIA Working Papers 2006-E62, Carnegie Mellon University, Tepper School of Business.
    17. Propper, Carol, 2018. "Competition in health care: lessons from the English experience," Health Economics, Policy and Law, Cambridge University Press, vol. 13(3-4), pages 492-508, July.
    18. F. Moscone & E. Tosetti & G. Vittadini, 2012. "Social interaction in patients’ hospital choice: evidence from Italy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 453-472, April.
    19. Pope, Devin G., 2009. "Reacting to rankings: Evidence from "America's Best Hospitals"," Journal of Health Economics, Elsevier, vol. 28(6), pages 1154-1165, December.
    20. Varkevisser, Marco & van der Geest, Stéphanie A. & Schut, Frederik T., 2012. "Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands," Journal of Health Economics, Elsevier, vol. 31(2), pages 371-378.
    21. Pilny, Adam & Mennicken, Roman, 2014. "Does Hospital Reputation Influence the Choice of Hospital?," Ruhr Economic Papers 516, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    22. Jung, Kyoungrae & Feldman, Roger & Scanlon, Dennis, 2011. "Where would you go for your next hospitalization?," Journal of Health Economics, Elsevier, vol. 30(4), pages 832-841, July.
    23. 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.
    24. Beaulieu, Nancy Dean, 2002. "Quality information and consumer health plan choices," Journal of Health Economics, Elsevier, vol. 21(1), pages 43-63, January.
    25. Christian Bünnings & Hendrik Schmitz & Harald Tauchmann & Nicolas R. Ziebarth, 2019. "The Role of Prices Relative to Supplemental Benefits and Service Quality in Health Plan Choice," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 86(2), pages 415-449, June.
    26. repec:zbw:rwirep:0516 is not listed on IDEAS
    27. Martin Gaynor & Carol Propper & Stephan Seiler, 2016. "Free to Choose? Reform, Choice, and Consideration Sets in the English National Health Service," American Economic Review, American Economic Association, vol. 106(11), pages 3521-3557, November.
    28. repec:ecj:econjl:v:122:y:2012:i::p:400-417 is not listed on IDEAS
    29. Chernew, Michael & Gowrisankaran, Gautam & Scanlon, Dennis P., 2008. "Learning and the value of information: Evidence from health plan report cards," Journal of Econometrics, Elsevier, vol. 144(1), pages 156-174, May.
    30. Corinna Hentschker & Roman Mennicken, 2015. "The Volume‐Outcome Relationship and Minimum Volume Standards – Empirical Evidence for Germany," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 644-658, June.
    31. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
    32. Scanlon, Dennis P. & Chernew, Michael & McLaughlin, Catherine & Solon, Gary, 2002. "The impact of health plan report cards on managed care enrollment," Journal of Health Economics, Elsevier, vol. 21(1), pages 19-41, January.
    33. Mennicken, Roman & Kolodziej, Ingo W.K. & Augurzky, Boris & Kreienberg, Rolf, 2014. "Concentration of gynaecology and obstetrics in Germany: Is comprehensive access at stake?," Health Policy, Elsevier, vol. 118(3), pages 396-406.
    34. Hodgkin, Dominic, 1996. "Specialized service offerings and patients' choice of hospital: The case of cardiac catheterization," Journal of Health Economics, Elsevier, vol. 15(3), pages 305-332, June.
    35. Werner, Rachel M. & Norton, Edward C. & Konetzka, R. Tamara & Polsky, Daniel, 2012. "Do consumers respond to publicly reported quality information? Evidence from nursing homes," Journal of Health Economics, Elsevier, vol. 31(1), pages 50-61.
    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. Sara Casagrande & Bruno Dallago, 2022. "To Be, or Not to Be: The Role of Self-Perception in European Countries’ Performance Assessment," Sustainability, MDPI, vol. 14(20), pages 1-23, October.
    2. Hendrik Schmitz & Magdalena A. Stroka‐Wetsch, 2020. "Determinants of nursing home choice: Does reported quality matter?," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 766-777, July.
    3. Sá, Luís & Straume, Odd Rune, 2024. "Hospital competition when patients learn through experience," Journal of Health Economics, Elsevier, vol. 97(C).
    4. Brüll, Eduard & Rostam-Afschar, Davud & Schlenker, Oliver, 2025. "Cut off from new competition: Threat of entry and quality of primary care," Labour Economics, Elsevier, vol. 92(C).
    5. Hai Yuan & Hang Li & ZhaoWei Hou, 2020. "Is it worth outsourcing essential public health services in China?—Evidence from Beilin District of Xi'an," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(6), pages 1486-1502, November.
    6. Sriubaite, Ieva, 2021. "Who will be the mediator? Local politics and hospital closures in Germany," Ruhr Economic Papers 897, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    7. Lippi Bruni, Matteo & Ugolini, Cristina & Verzulli, Rossella, 2021. "Should I wait or should I go? Travelling versus waiting for better healthcare," Regional Science and Urban Economics, Elsevier, vol. 89(C).
    8. Chen, Qiulin & Xu, Duo & Fu, Hongqiao & Yip, Winnie, 2022. "Distance effects and home bias in patient choice on the Internet: Evidence from an online healthcare platform in China," China Economic Review, Elsevier, vol. 72(C).
    9. Kai Shen Lim & Wei Aun Yap & Winnie Yip, 2022. "Consumer choice and public‐private providers: The role of perceived prices," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1898-1925, September.
    10. Helmut Herwartz & Christoph Strumann, 2024. "Too many cooks could spoil the broth: choice overload and the provision of ambulatory health care," International Journal of Health Economics and Management, Springer, vol. 24(3), pages 357-373, September.
    11. Dahlgren, Cecilia & Dackehag, Margareta & Wändell, Per & Rehnberg, Clas, 2021. "Simply the best? The impact of quality on choice of primary healthcare provider in Sweden," Health Policy, Elsevier, vol. 125(11), pages 1448-1454.
    12. David Kuklinski & Justus Vogel & Alexander Geissler, 2021. "The impact of quality on hospital choice. Which information affects patients’ behavior for colorectal resection or knee replacement?," Health Care Management Science, Springer, vol. 24(1), pages 185-202, March.
    13. Christoph Strumann & Alexander Geissler & Reinhard Busse & Christoph Pross, 2022. "Can competition improve hospital quality of care? A difference-in-differences approach to evaluate the effect of increasing quality transparency on hospital quality," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1229-1242, September.
    14. Jinyang Chen & Chaoqun Wang, 2023. "“The reputation premium”: does hospital ranking improvement lead to a higher healthcare spending?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(5), pages 817-830, July.
    15. Alex Bawuah & Simon Appleton & Yang Li, 2024. "The effect of health facility ownership on perceived healthcare quality: evidence from Ghana," International Journal of Health Economics and Management, Springer, vol. 24(4), pages 571-593, December.

    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. Daniel Avdic & Tugba Bueyuekdurmus & Giuseppe Moscelli & Adam Pilny & Ieva Sriubaite, 2018. "Subjective and objective quality reporting and choice of hospital: Evidence from maternal care services in Germany," CINCH Working Paper Series 1803, Universitaet Duisburg-Essen, Competent in Competition and Health.
    2. Lippi Bruni, Matteo & Ugolini, Cristina & Verzulli, Rossella, 2021. "Should I wait or should I go? Travelling versus waiting for better healthcare," Regional Science and Urban Economics, Elsevier, vol. 89(C).
    3. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
    4. David Kuklinski & Justus Vogel & Alexander Geissler, 2021. "The impact of quality on hospital choice. Which information affects patients’ behavior for colorectal resection or knee replacement?," Health Care Management Science, Springer, vol. 24(1), pages 185-202, March.
    5. M. Lippi Bruni & C. Ugolini & R. Verzulli, 2018. "Disentangling the effect of waiting times on hospital choice: Evidence from a panel data analysis," Working Papers wp1118, Dipartimento Scienze Economiche, Universita' di Bologna.
    6. Empel, Giovanni & Gravelle, Hugh & Santos, Rita, 2023. "Does quality affect choice of family physician? Evidence from patients changing general practice without changing address," Economic Modelling, Elsevier, vol. 126(C).
    7. Martini, Gianmaria & Levaggi, Rosella & Spinelli, Daniele, 2022. "Is there a bias in patient choices for hospital care? Evidence from three Italian regional health systems," Health Policy, Elsevier, vol. 126(7), pages 668-679.
    8. K. John McConnell & Richard C. Lindrooth & Douglas R. Wholey & Thomas M. Maddox & Nick Bloom, 2016. "Modern Management Practices and Hospital Admissions," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 470-485, April.
    9. Hugh Gravelle & Rita Santos & Luigi Siciliani & Rosalind Goudie, 2012. "Hospital Quality Competition Under Fixed Prices," Working Papers 080cherp, Centre for Health Economics, University of York.
    10. Visa Pitkänen & Ismo Linnosmaa, 2021. "Choice, quality and patients’ experience: evidence from a Finnish physiotherapy service," International Journal of Health Economics and Management, Springer, vol. 21(2), pages 229-245, June.
    11. Rita Santos & Hugh Gravelle & Carol Propper, 2013. "Does quality affect patients’ choice of doctor? Evidence from the UK," Working Papers 088cherp, Centre for Health Economics, University of York.
    12. Moscelli, Giuseppe & Siciliani, Luigi & Gutacker, Nils & Gravelle, Hugh, 2016. "Location, quality and choice of hospital: Evidence from England 2002–2013," Regional Science and Urban Economics, Elsevier, vol. 60(C), pages 112-124.
    13. Moscone, Francesco & Siciliani, Luigi & Tosetti, Elisa & Vittadini, Giorgio, 2020. "Do public and private hospitals differ in quality? Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 83(C).
    14. Puck Beukers & Ron Kemp & Marco Varkevisser, 2014. "Patient hospital choice for hip replacement: empirical evidence from the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(9), pages 927-936, December.
    15. Mariétou H. Ouayogodé & Kurt E. Schnier, 2021. "Patient selection in the presence of regulatory oversight based on healthcare report cards of providers: the case of organ transplantation," Health Care Management Science, Springer, vol. 24(1), pages 160-184, March.
    16. Wang, Justin & Hockenberry, Jason & Chou, Shin-Yi & Yang, Muzhe, 2011. "Do bad report cards have consequences? Impacts of publicly reported provider quality information on the CABG market in Pennsylvania," Journal of Health Economics, Elsevier, vol. 30(2), pages 392-407, March.
    17. Sriubaite, Ieva, 2021. "Who will be the mediator? Local politics and hospital closures in Germany," Ruhr Economic Papers 897, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    18. Rita Santos & Hugh Gravelle & Carol Propper, 2013. "Does quality affect patients’ choice of doctor? Evidence from the UK," The Centre for Market and Public Organisation 13/306, The Centre for Market and Public Organisation, University of Bristol, UK.
    19. Levaggi, Laura & Levaggi, Rosella, 2020. "Is there scope for mixed markets in the provision of hospital care?," Social Science & Medicine, Elsevier, vol. 247(C).
    20. Paolo Berta & Gianmaria Martini & Francesco Moscone & Giorgio Vittadini, 2016. "The association between asymmetric information, hospital competition and quality of healthcare: evidence from Italy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 907-926, October.

    More about this item

    Keywords

    Competition; Provider choice; Maternal care; Quality;
    All these keywords.

    JEL classification:

    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    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:eee:jhecon:v:68:y:2019:i:c:s0167629618307495. 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: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    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.