OBRA 1987 and the quality of nursing home care.

International Journal of Health Care Finance and Economics
Virender KumarWilliam E Encinosa

Abstract

Because minimum government standards for quality regulate only part of the market failure, they may have unintended effects. We present a general theory of how government regulation of quality of care may affect different market segments, and test the hypotheses for the nursing home market. OBRA 1987 was a sweeping government reform to improve the quality of nursing home care. We study how the effect of OBRA on the quality of nursing home care, measured by resident outcomes, varied with nursing home profitability. Using a semi-parametric method to control for the endogenous effects of regulation, we found that this landmark legislation had a negative effect on the quality of care in less profitable nursing homes, but improved the quality in more profitable nursing homes during the initial period after OBRA. But, this legislation had no statistically significant effect in the later period when the regulation was weakly enforced.

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Citations

Apr 14, 2012·Journal of Aging & Social Policy·Catherine HawesCharles D Phillips
Jul 16, 2010·The Gerontologist·Nicholas G Castle, Jamie C Ferguson
May 19, 2010·Qualitative Health Research·Cathleen S Colón-EmericRuth Anderson
Oct 28, 2015·Journal of the American Geriatrics Society·Joshua ChodoshJanet C Frank
Jul 16, 2015·Medical Care Research and Review : MCRR·Seung Chun PaekNatthani Meemon
May 17, 2008·Journal of the American Geriatrics Society·Heather M YoungTiffany Allen

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