Assessing the quality of public services: For-profits, chains, and concentration in the hospital market.

Autor: Kunz JS; Monash Business School (Centre for Health Economics), Monash University, Melbourne, Victoria, Australia., Propper C; Monash Business School (Centre for Health Economics), Monash University, Melbourne, Victoria, Australia.; Department of Economics and Public Policy, Imperial College London, London, UK., Staub KE; Department of Economics, The University of Melbourne, Melbourne, Victoria, Australia., Winkelmann R; Department of Economics, University of Zürich, Zürich, Switzerland.
Jazyk: angličtina
Zdroj: Health economics [Health Econ] 2024 Sep; Vol. 33 (9), pp. 2162-2181. Date of Electronic Publication: 2024 Jun 17.
DOI: 10.1002/hec.4861
Abstrakt: We examine variation in US hospital quality across ownership, chain membership, and market concentration. We propose a new measure of quality derived from penalties imposed on hospitals under the flagship Hospital Readmissions Reduction Program, and use regression models to risk-adjust for hospital characteristics and county demographics. While the overall association between for-profit ownership and quality is negative, there is evidence of substantial heterogeneity. The quality of for-profit relative to non-profit hospitals declines with increasing market concentration. Moreover, the quality gap is primarily driven by for-profit chains. While the competition result mirrors earlier findings in the literature, the chain result appears to be new: it suggests that any potential quality gains afforded by chains are mostly realized by not-for-profit hospitals.
(© 2024 The Author(s). Health Economics published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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