Hospital uncompensated care and patient experience: An instrumental variable approach.
hospital quality
instrumental variables
uncompensated care
Journal
Health services research
ISSN: 1475-6773
Titre abrégé: Health Serv Res
Pays: United States
ID NLM: 0053006
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
pubmed:
11
1
2019
medline:
30
1
2020
entrez:
11
1
2019
Statut:
ppublish
Résumé
Examine the endogenous relationship between uncompensated care and hospital patient experience scores. The Hospital Consumer Assessment of Healthcare Providers and Systems Survey, CMS Healthcare Cost Report Information System, and the US Census Bureau. The exogenous change in uncompensated care caused by the 2014 Medicaid expansion was exploited to measure the effect of uncompensated care on patient experience scores using a 2SLS regression with instrumental variables approach. U.S. general, short-term hospitals whose DSH status remained constant and had nonmissing data for 2011-2015, which totaled 969 unique hospitals per year. The effect of uncompensated care on patient experience was in the predicted direction, with three of the 10 measures being statistically significant. A one percentage point increase in uncompensated care costs resulted in a 0.25-0.50 percentage point decrease in select patient experience scores. Results indicate a weak relationship between uncompensated care and patient experience scores, as a reduction in uncompensated care is related to quality improvement for some hospitals. These findings have implications for hospitals as they navigate changing reimbursement structures and policy makers considering changes to Obama-era health care reforms.
Identifiants
pubmed: 30628070
doi: 10.1111/1475-6773.13111
pmc: PMC6505421
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
603-612Informations de copyright
© Health Research and Educational Trust.
Références
J Health Polit Policy Law. 2001 Feb;26(1):81-105
pubmed: 11253456
J Hosp Mark Public Relations. 2010 Jul;20(2):116-30
pubmed: 20582851
JAMA. 1993 Aug 18;270(7):845-9
pubmed: 8340984
Health Aff (Millwood). 2011 Oct;30(10):1904-11
pubmed: 21976334
Health Econ. 2008 Aug;17(8):977-95
pubmed: 18157911
Health Serv Res. 2018 Jun;53(3):1562-1580
pubmed: 28480593
Health Serv Res. 2006 Aug;41(4 Pt 1):1159-80
pubmed: 16899001
Health Serv Res. 2005 Aug;40(4):1056-77
pubmed: 16033492
N Engl J Med. 2012 Apr 12;366(15):1366-9
pubmed: 22455752
Med Care Res Rev. 2007 Dec;64(6):731-44
pubmed: 18045985
Inquiry. 2005 Spring;42(1):60-72
pubmed: 16013586
J Health Econ. 2016 Sep;49:28-45
pubmed: 27372577
Ann Intern Med. 2010 Sep 7;153(5):299-306
pubmed: 20820039
Health Aff (Millwood). 1997 Jul-Aug;16(4):30-47
pubmed: 9248148
Acad Emerg Med. 2001 Nov;8(11):1064-9
pubmed: 11691669
Rural Policy Brief. 2004 May 01;9(4 (PB2004-4)):1-8
pubmed: 15228056
N Engl J Med. 2013 Jan 17;368(3):201-3
pubmed: 23268647
Am J Manag Care. 2011 Jan;17(1):41-8
pubmed: 21348567
Health Aff (Millwood). 2001 Jul-Aug;20(4):159-68
pubmed: 11463072
Health Serv Res. 2019 Jun;54(3):603-612
pubmed: 30628070
Med Care. 2007 Jun;45(6):579-83
pubmed: 17515786
N Engl J Med. 2008 Oct 30;359(18):1921-31
pubmed: 18971493
Arch Intern Med. 2012 Sep 10;172(16):1204-10
pubmed: 22801941
Health Aff (Millwood). 2015 Jul;34(7):1170-9
pubmed: 26153312
Patient. 2016 Oct;9(5):445-55
pubmed: 27002317
Health Aff (Millwood). 2014 Aug;33(8):1314-22
pubmed: 25092831
JAMA. 2016 Oct 11;316(14):1475-1483
pubmed: 27727384
Health Serv Res. 2016 Aug;51(4):1368-87
pubmed: 26611494
Health Aff (Millwood). 2005 Jul-Aug;24(4):1047-56
pubmed: 16012145
Health Aff (Millwood). 2015 Mar;34(3):398-405
pubmed: 25732489
J Health Econ. 2003 Mar;22(2):243-69
pubmed: 12606145
N Engl J Med. 2009 Dec 31;361(27):2637-45
pubmed: 20042755
Med Care Res Rev. 2007 Apr;64(2):148-68
pubmed: 17406018
Inquiry. 2000 Fall;37(3):253-67
pubmed: 11111283
Health Aff (Millwood). 2016 Aug 1;35(8):1471-9
pubmed: 27503973