IDEAS home Printed from https://ideas.repec.org/a/tpr/amjhec/v5y2019i2p165-190.html
   My bibliography  Save this article

Consumer Response to Composite Ratings of Nursing Home Quality

Author

Listed:
  • Marcelo Coca Perraillon

    (Department of Health Systems, Management, and Policy, University of Colorado, Anschutz Medical Campus)

  • R. Tamara Konetzka

    (Department of Public Health Sciences, University of Chicago)

  • Daifeng He

    (Department of Economics, Swarthmore College)

  • Rachel M. Werner

    (University of Pennsylvania)

Abstract

Health-care report cards are intended to address information asymmetries and enable consumers to choose providers of better quality. However, the form of the information may matter to consumers. Nursing Home Compare, a website that publishes report cards for nursing homes, went from publishing a large set of indicators to a composite rating in which nursing homes are assigned one to five stars. We evaluate whether the simplified ratings motivated consumers to choose better-rated nursing homes. We use a regression discontinuity design to estimate changes in new admissions six months after the publication of the ratings. Our main results show that nursing homes that obtained an additional star gained more admissions, with heterogeneous effects depending on baseline number of stars. We conclude that the form of quality reporting matters to consumers, and that the increased use of composite ratings is likely to increase consumer response.

Suggested Citation

  • Marcelo Coca Perraillon & R. Tamara Konetzka & Daifeng He & Rachel M. Werner, 2019. "Consumer Response to Composite Ratings of Nursing Home Quality," American Journal of Health Economics, MIT Press, vol. 5(2), pages 165-190, Spring.
  • Handle: RePEc:tpr:amjhec:v:5:y:2019:i:2:p:165-190
    as

    Download full text from publisher

    File URL: http://www.mitpressjournals.org/doi/pdf/10.1162/ajhe_a_00115
    Download Restriction: Access to PDF is restricted to subscribers.
    ---><---

    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. David Dranove & Mark A. Satterthwaite, 1992. "Monopolistic Competition When Price and Quality are Imperfectly Observable," RAND Journal of Economics, The RAND Corporation, vol. 23(4), pages 518-534, Winter.
    2. Richard Hirth & David Grabowski & Zhanlian Feng & Momotazur Rahman & Vincent Mor, 2014. "Effect of nursing home ownership on hospitalization of long-stay residents: an instrumental variables approach," International Journal of Health Economics and Management, Springer, vol. 14(1), pages 1-18, March.
    3. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    4. Andrew Gelman & Guido Imbens, 2019. "Why High-Order Polynomials Should Not Be Used in Regression Discontinuity Designs," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 37(3), pages 447-456, July.
    5. Grabowski, David C. & Feng, Zhanlian & Hirth, Richard & Rahman, Momotazur & Mor, Vincent, 2013. "Effect of nursing home ownership on the quality of post-acute care: An instrumental variables approach," Journal of Health Economics, Elsevier, vol. 32(1), pages 12-21.
    6. Daifeng He & R. Tamara Konetzka, 2015. "Public Reporting and Demand Rationing: Evidence from the Nursing Home Industry," Health Economics, John Wiley & Sons, Ltd., vol. 24(11), pages 1437-1451, November.
    7. 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. Christopher S. Brunt, 2023. "Assessing the impact of enforcement and compliance with minimum staffing standards on the quality of care in nursing homes: Evidence from the Centers for Medicare and Medicaid Services' staff star rat," Health Economics, John Wiley & Sons, Ltd., vol. 32(2), pages 235-276, February.
    2. Templeton, Zachary S. & Apathy, Nate C. & Konetzka, R. Tamara & Skira, Meghan M. & Werner, Rachel M., 2023. "The health effects of nursing home specialization in post-acute care," Journal of Health Economics, Elsevier, vol. 92(C).
    3. Kim, Tami & Martin, Daniel, 2021. "What do consumers learn from regulator ratings? Evidence from restaurant hygiene quality disclosures," Journal of Economic Behavior & Organization, Elsevier, vol. 185(C), pages 234-249.
    4. Cutler, Henry & Gu, Yuanyuan & Bilgrami, Anam & Partington, Andrew, 2023. "The 2021 proposal to increase market forces in the Australian residential aged-care sector," Health Policy, Elsevier, vol. 127(C), pages 60-65.

    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. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    2. Cornell, Portia Y. & Grabowski, David C. & Norton, Edward C. & Rahman, Momotazur, 2019. "Do report cards predict future quality? The case of skilled nursing facilities," Journal of Health Economics, Elsevier, vol. 66(C), pages 208-221.
    3. Arteaga, Irma & Heflin, Colleen & Gable, Sara, 2016. "The impact of aging out of WIC on food security in households with children," Children and Youth Services Review, Elsevier, vol. 69(C), pages 82-96.
    4. Thushyanthan Baskaran & Sonia Bhalotra & Brian Min & Yogesh Uppal, 2024. "Women legislators and economic performance," Journal of Economic Growth, Springer, vol. 29(2), pages 151-214, June.
    5. Sun, Ang & Zhao, Yaohui, 2016. "Divorce, abortion, and the child sex ratio: The impact of divorce reform in China," Journal of Development Economics, Elsevier, vol. 120(C), pages 53-69.
    6. Koichiro Ito & Shuang Zhang, 2020. "Willingness to Pay for Clean Air: Evidence from Air Purifier Markets in China," Journal of Political Economy, University of Chicago Press, vol. 128(5), pages 1627-1672.
    7. Adam C. Sales & Ben B. Hansen, 2020. "Limitless Regression Discontinuity," Journal of Educational and Behavioral Statistics, , vol. 45(2), pages 143-174, April.
    8. Hasan, Rana & Jiang, Yi & Rafols, Radine Michelle, 2021. "Place-based preferential tax policy and industrial development: Evidence from India’s program on industrially backward districts," Journal of Development Economics, Elsevier, vol. 150(C).
    9. Christelis, Dimitris & Georgarakos, Dimitris & Sanz-de-Galdeano, Anna, 2020. "The impact of health insurance on stockholding: A regression discontinuity approach," Journal of Health Economics, Elsevier, vol. 69(C).
    10. Ari Hyytinen & Jaakko Meriläinen & Tuukka Saarimaa & Otto Toivanen & Janne Tukiainen, 2018. "When does regression discontinuity design work? Evidence from random election outcomes," Quantitative Economics, Econometric Society, vol. 9(2), pages 1019-1051, July.
    11. Herr, A. & Saric, A., 2016. "The Welfare Effects of Single Rooms in German Nursing Homes: A Structural Approach," Health, Econometrics and Data Group (HEDG) Working Papers 16/23, HEDG, c/o Department of Economics, University of York.
    12. Franz Buscha & Matt Dickson, 2018. "A Note on the Wage Effects of the 1972 Raising of the School Leaving Age in Scotland and Northern Ireland," Scottish Journal of Political Economy, Scottish Economic Society, vol. 65(5), pages 572-582, November.
    13. Cellini, Roberto & Siciliani, Luigi & Straume, Odd Rune, 2018. "A dynamic model of quality competition with endogenous prices," Journal of Economic Dynamics and Control, Elsevier, vol. 94(C), pages 190-206.
    14. Francesco Angelini & Paolo Figini & Veronica Leoni, 2024. "High tide, low price? Flooding alerts and hotel prices in Venice," Tourism Economics, , vol. 30(4), pages 876-899, June.
    15. Lena Abou El-Komboz & Anna Kerkhof & Johannes Loh, 2023. "Platform Partnership Programs and Content Supply: Evidence from the YouTube “Adpocalypse”," CESifo Working Paper Series 10363, CESifo.
    16. Meltem Dayioglu & Müşerref Küçükbayrak & Semih Tumen, 2022. "The impact of age-specific minimum wages on youth employment and education: a regression discontinuity analysis," International Journal of Manpower, Emerald Group Publishing Limited, vol. 43(6), pages 1352-1377, March.
    17. Erasmo Giambona & Rafael P. Ribas, 2023. "Unveiling the Price of Obscenity: Evidence From Closing Prostitution Windows in Amsterdam," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(3), pages 677-705, June.
    18. Dan Anderberg & Jesper Bagger & V. Bhaskar & Tanya Wilson, 2019. "Marriage market equilibrium, qualifications, and ability," CESifo Working Paper Series 7570, CESifo.
    19. Miron Tequame & Nyasha Tirivayi, 2015. "Higher education and fertility: Evidence from a natural experiment in Ethiopia," CINCH Working Paper Series 1509, Universitaet Duisburg-Essen, Competent in Competition and Health, revised Aug 2015.
    20. Claire MacPherson & Olivier Sterck, 2019. "Humanitarian vs. Development Aid for Refugees: Evidence from a Regression Discontinuity Design," CSAE Working Paper Series 2019-15, Centre for the Study of African Economies, University of Oxford.

    More about this item

    Keywords

    report cards; quality; star rating; nursing home; regression discontinuity;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L15 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Information and Product Quality

    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:tpr:amjhec:v:5:y:2019:i:2:p:165-190. 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: Kelly McDougall (email available below). General contact details of provider: https://direct.mit.edu/journals .

    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.