Do Health Care Report Cards Cause Providers to Select Patients and Raise Quality of Care?

Yijuan Chen and Juergen Meinecke ()

No 657, CEPR Discussion Papers from Centre for Economic Policy Research, Research School of Economics, Australian National University

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 health care providers. During the ?rst three 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 non–linear difference–in– differences model and derive asymptotic standard errors. The mortality rate for bypass patients decreases by only 0.05 percentage points due to 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.

Keywords: health care report cards; provider moral hazard; quality improvement; difference–in–differences estimation (search for similar items in EconPapers)
JEL-codes: C23 D82 I18 (search for similar items in EconPapers)
Date: 2012-01
New Economics Papers: this item is included in nep-cta, nep-ecm and nep-hea
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Citations: View citations in EconPapers (4)

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Journal Article: DO HEALTHCARE REPORT CARDS CAUSE PROVIDERS TO SELECT PATIENTS AND RAISE QUALITY OF CARE? (2012)
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Persistent link: https://EconPapers.repec.org/RePEc:auu:dpaper:657

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