Do healthcare report cards cause providers to select patients and raise quality of care?

Health Economics
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 1990 s, 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.

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Citations

Jun 10, 2015·Health Economics, Policy, and Law·Jeroen Postma, Anne-Fleur Roos
Dec 17, 2014·Health Services Research·Andrew M RyanJustin B Dimick
Jan 28, 2014·Journal of Health Economics·Shin-Yi ChouYi Lu
Feb 22, 2014·Health Economics, Policy, and Law·Hugh McLeodMartin Powell
Sep 26, 2017·Clinical Spine Surgery : a Spine Publication·Fady Y HijjiKern Singh
Sep 1, 2017·Orthopaedic Journal of Sports Medicine·Blaine T ManningBernard R Bach
Sep 7, 2017·Foot & Ankle Specialist·Blaine T ManningSimon Lee
Feb 9, 2018·Health Economics, Policy, and Law·Carol Propper
Mar 23, 2018·Australian Health Review : a Publication of the Australian Hospital Association·Charissa ZagaSophie Hill
Dec 15, 2015·Spine·Blaine T ManningKern Singh
Sep 1, 2013·Forum for Health Economics & Policy·Gregory Bloss, John G Haaga
Nov 16, 2019·International Journal of Health Economics and Management·Xiaoxue Li
Jul 5, 2021·Journal of Health Economics·Yijuan Chen, Peter Sivey

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