Can Ranking Hospitals on the Basis of Patients Travel Distances Improve Quality of Care?

By Kessler, Daniel P.

Book Id: WPLBN0000186928
Format Type: PDF eBook
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Title:	Can Ranking Hospitals on the Basis of Patients Travel Distances Improve Quality of Care?
Author:	Kessler, Daniel P.
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Language:	English
Subject:	Trade, Import and export controls, Federal Trade Commission (U.S.)
Collections:	Economics Publications Collection, Federal Trade Commission
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Publisher:	Government Printing Office


Citation APA MLA Chicago Kessler, D. P. (n.d.). Can Ranking Hospitals on the Basis of Patients Travel Distances Improve Quality of Care?. Retrieved from https://self.gutenberg.org/

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Government Reference Publication

Excerpt
Abstract: Conventional outcomes report cards? public disclosure of information about the patientbackground- adjusted health outcomes of individual hospitals and physicians -- may help improve quality, but they may also encourage providers to ?game? the system by avoiding sick and/or seeking healthy patients. In this paper, I propose an alternative approach: ranking hospitals on the basis of the travel distances of their Medicare patients. At least in theory, a distance report card could dominate conventional outcomes report cards: a distance report card might measure quality of care at least as well but suffer less from selection problems. I use data on elderly Medicare beneficiaries with heart attack and stroke from 1994 and 1999 to show that a distance report card would be both valid ? that is, correlated with true quality ? and able to distinguish confidently among hospitals ? that is, able to reject at conventional significance levels the hypothesis that the true quality of a low-ranked hospital was the same as the quality of the average hospital. The hypothetical distance report card I propose compares favorably to (although does not necessarily dominate) the California AMI outcomes report card.