Is the quality of hospital care price sensitive? Regression kink estimates from a volume dependent price setting scheme

Søren Kristensen, Eduardo Fe (), Mickael Bech and Jan Mainz ()
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Eduardo Fe: Health Economics Research Unit, University of Oxford, Postal: UK
Jan Mainz: COHERE, Institute of Public Health, University of Southern Denmark, Postal: Campusvej 55, DK-5230 Odense M, Denmark

No 2013:4, DaCHE discussion papers from University of Southern Denmark, Dache - Danish Centre for Health Economics

Abstract: This paper estimates the price sensitivity of the quality of acute stroke care using a regression kink design. When Danish hospitals reach a production target, marginal tari s for treating acute stroke patients falls by 50%{100%. This reimbursement scheme allow us to identify local average treatment ef- fects of reimbursement tari s on the quality of hospital care. A rich data set of the process quality of stroke care allows us to detect minor changes in the quality of care that are important for the long term outcomes but do not lead to dead or readmission captured by commonly employed outcome indicators. Hospitals that were exposed to reductions in the marginal tari of less than 100% did not appear to respond in quality to reductions in tari s. Hospital for which the marginal tari for acute stroke patients dropped to 0 responded to tari reductions by slightly decreasing the level of quality for acute stroke care patients. The estimated size of the e ect is minor but robust to various tests of sensitivity, indicating that the estimated e ect is not spurious.

Keywords: Quality of health care; Price regulation; Activity based reimbursement; Supply side incentives (search for similar items in EconPapers)
JEL-codes: H42 I18 L51 (search for similar items in EconPapers)
Pages: 36 pages
Date: 2013-06-24
New Economics Papers: this item is included in nep-eur and nep-hea
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Citations: View citations in EconPapers (2)

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