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Do Healthcare Report Cards Cause Providers To Select Patients And Raise Quality Of Care?

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  • Yijuan Chen
  • Juergen Meinecke

Abstract

We exploit a brief period of asymmetric information during the implementation of Pennsylvania's ‘report card’ scheme for coronary artery bypass graft surgery to test for improvements in quality of care and selection of patients by healthcare providers. During the first 3 years of the 1990s, providers in Pennsylvania had an incentive to bias report cards by selecting patients strategically, with patients having no access to the report cards. This dichotomy enables us to separate providers' selection of patients from patients' selection of providers. Using data from the Nationwide Inpatient Sample, we estimate a nonlinear difference‐in‐differences model and derive asymptotic standard errors. The mortality rate for bypass patient decreases by only 0.05 percentage points because of the report cards, which we interpret as evidence that quality of bypass surgery did not improve (at least in the short‐term) nor did patient selection by providers occur. Our timing, estimation, and asymptotics are readily applicable to many other report card schemes. Copyright © 2012 John Wiley & Sons, Ltd.

Suggested Citation

  • Yijuan Chen & Juergen Meinecke, 2012. "Do Healthcare Report Cards Cause Providers To Select Patients And Raise Quality Of Care?," Health Economics, John Wiley & Sons, Ltd., vol. 21(S1), pages 33-55, June.
    • Handle: RePEc:wly:hlthec:v:21:y:2012:i:s1:p:33-55
    DOI: 10.1002/hec.2775
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    Cited by:

    1. Chen, Yijuan & Sivey, Peter, 2021. "Hospital report cards: Quality competition and patient selection," Journal of Health Economics, Elsevier, vol. 78(C).
    2. Chou, Shin-Yi & Deily, Mary E. & Li, Suhui & Lu, Yi, 2014. "Competition and the impact of online hospital report cards," Journal of Health Economics, Elsevier, vol. 34(C), pages 42-58.
    3. Xiaoxue Li, 2020. "Quality information disclosure and health insurance demand: evidence from VA hospital report cards," International Journal of Health Economics and Management, Springer, vol. 20(2), pages 177-199, June.
    4. Yang, Ou & Chan, Marc K. & Cheng, Terence C. & Yong, Jongsay, 2020. "Cream skimming: Theory and evidence from hospital transfers and capacity utilization," Journal of Economic Behavior & Organization, Elsevier, vol. 173(C), pages 68-87.

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    More about this item

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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