Wübker, Ansgar and Sauerland, Dirk and Wübker, Achim (2008): Does better information about hospital quality affect patients’ choice? Empirical findings from Germany.
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Abstract
Background: Economic theory strongly suggests that better information about the quality of care affects patients’ choice of health service providers. However, we have little empirical evidence about the impact of information provided on provider’s choice in Germany. Problem: In Germany, we recently find publicly available information about hospital quality. For example, 50 percent of the hospitals in the Rhine-Ruhr area do now publish their quality data voluntarily in a comprehensive, understandable and well prepared publication. Empirically, we see a strong demand for this publication. However, we do not have information so far, if – and how – this information affect patients’ choice of hospitals. Data and methodology: We take cross sectional time series data from more than 700.000 patients in the Rhine-Ruhr area and in the Cologne-Bonn area (control group) for the time period 2003 to 2006, i.e. 16 quarters. We examine whether the publication of quality information affects market shares and number of cases of the hospitals as well as travelling distance that patients accept to get to the hospital of their choice. In order to account for hospital-specific heterogeneity, we use fixed and random effects models. Results: First: Hospitals, which publish their quality data voluntarily, do attract more patients – compared to such hospital, that do not publish their quality data. Second: In the group of the publishing hospitals, hospitals with a higher than average quality slightly increased their market shares, whereas hospitals with a lower than average quality lost market shares. Conclusion: The provision of quality data has a significant impact on hospital choice: a higher quality leads to a higher demand. Based on these finding decision makers in hospitals have strong incentives (i) to make quality information publicly available and (ii) to keep their quality of care high.
Item Type: | MPRA Paper |
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Original Title: | Does better information about hospital quality affect patients’ choice? Empirical findings from Germany |
Language: | English |
Keywords: | Keywords: Quality of care, Information, Hospital Choice JEL Classifications: I 12, C 33 |
Subjects: | I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets I - Health, Education, and Welfare > I1 - Health > I12 - Health Behavior |
Item ID: | 10479 |
Depositing User: | Ansgar Wübker |
Date Deposited: | 14 Sep 2008 06:35 |
Last Modified: | 28 Sep 2019 13:00 |
References: | AOK – BUNDESVERBAND (2007), Website, in: http://www.aok-bv.de/aok/daten/index.html [abgerufen: 28.11.2007]. BAKER, D.W ET AL. (2003), The effect of publicly reporting hospital performance on mar-ket share and risk-adjusted mortality at high-mortality hospitals, in: Medical Care., Vol. 41, pp. 729–740. BQS – BUNDESGESCHÄFTSSTELLE FÜR QUALITÄTSSICHERUNG (2007), Website, in: http: //www.bqs.outcome.de [abgerufen: 28.11.2007]. BRECKENKAMP, J. WISKOW, C. AND U. LAASER (2007), Progress on quality management in the German health system – a long and winding road, in: Health Research Policy and Systems, Vol. 5, p. 1-11. CASALINO, L.P. ET AL. (2007), General Internists' Views On Pay-For-Performance And Public Reporting Of Quality Scores: A National Survey., in: Health Affairs (Millwood), Vol. 26, pp. 492–499. CHERNEW, M., GOWRISANKARAN, G. AND D. SCANLON (2007), Learning and the value of information: The case of hospital report cards, in: Journal of Econometrics, Forthcoming (Also: National Bureau of Economic Research, Working Paper 8589). CUTLER, D.M., HUCKMAN, R.S. AND M.B. LANDRUM (2004), The Role of Information in Medical Markets: An Analysis of Publicly Reported Outcomes in Cardiac Sur-gery, in: The American Economic Review, Vol. 94, pp. 342–346(5). DAFNY, D. AND D. DRANOVE, (2005), Do Report Cards Tell Patients Anything They Don’t Already Know? The Case of Medicare HMO Report Cards, in: National Bureau of Economic Research, Working Paper 11420. DEALEY, C. (2005), The factors that influence patients' choice of hospital and treatment, in: British journal of nursing, Vol. 14, pp. 576–579. DRANOVE, D. ET AL. (2003), Is More Information Better? The Effects of ‘Report Cards’ on Health Care Providers., in: Journal of Political Economy, Vol. 111, pp. 555–588. GERAEDTS, M. (2006), Qualitätsberichte deutscher Krankenhäuser und Qualitätsvergleiche von Einrichtungen des Gesundheitswesens aus Versichertensicht, in: BÖCKEN, J. ET AL. (Hrsg.), Gesundheitsversorgung und Gestaltungsoptionen aus der Per-spektive von Bevölkerung und Ärzten, Gütersloh, Bertelsmann-Stiftung, S. 154–170. HOLLAND, P.W. (1986), Statistics and Causal Inference, in: Journal of the American Statis-tical Association, Vol. 81, pp. 945–960. HOWARD, D.H. AND B. KAPLAN (2006), Do Report Cards Influence Hospital Choice? The Case of Kidney Transplantation, in: Inquiry, Vol 43, pp. 150–159. INITIATIVKREIS RUHRGEBIET (2005), Klinikführer Rhein-Ruhr 2005/2006, Klartext Verlag, Essen. INITIATIVKREIS RUHRGEBIET (2007), Website, in: http://www.i-r.de/Internet/DE/Initiativkreis/Mitglieder/ [abgerufen: 28.11.07]. JHA, A.K. AND A.M. EPSTEIN (2006), The Predictive Accuracy Of The New York State Coronary Artery Bypass Surgery Report-Card System, in: Health Affairs, Vol. 25, pp. 844–855. MA, C.T.A. (1994), Health Care Payment Systems: Cost and Quality Incentives, in: Journal of Economics and Management Strategy, Vol. 3, pp. 93–112. MANNION, R. AND M. GODDARD (2003), Public disclosure of comparative clinical per-formance data: lessons from the Scottish experience, in: Journal of evaluation in clinical practice, Vol. 9, pp. 277–286. MARSHALL, M.N. ET AL. (2000), The public release of performance data – what do we ex-pect to gain? A Review of evidence, in: Journal of the American Medical Asso-ciation, Vol. 14, pp. 1866–1874. MUKAMEL, D.B AND A.I. MUSHLIN (1998), Quality of Care Information Makes a Differ-ence: An Analysis of Market Share and Price Changes Following Publication of the New York State Cardiac Surgery Reports, in: Medical Care, Vol. 36, pp. 945-954. MUKAMEL, D.B. (2004/2005), Quality Report Cards, Selection of Cardiac Surgeons and Racial Disparities: A Study of the Publication of the NYS Cardiac Surgery Re-ports., in: Inquiry, Vol. 41, pp. 435–446. ROBINOWITZ, D.L. AND R.A. DUDLEY (2006), Public reporting of provider performance: Can its impact be made greater?, in: Annual Review of Public Health, Vol. 27, pp. 517–536. ROMANO, P.S. AND H. ZHOU (2004), Do well-publicized risk-adjusted outcomes reports affect hospital volume?, in: Medical Care, Vol. 42, pp. 367–377. SAUERLAND, D. (2003), Gesundheitspolitik in Deutschland, Reformbedarf und Entwick-lungsperspektiven, 2. Aufl., Gütersloh. SCHAEFFER, D. (2006), Bedarf an Patienteninformationen über das Krankenhaus. Eine Lite-raturanalyse, Bertelsmann Stiftung (Hrsg.), Gütersloh, in: http://www.bertelsmann-stiftung.de/bst/de/media/xcms_bst_dms_20030_20031_2.pdf. [abgerufen: 28.11.2007]. SCOTT, I.A. AND M. WARD (2006), Public Reporting of Hospital Outcomes Based on Ad-ministrative Data: Risks and Opportunities, in: The Medical Journal of Australia, Vol. 184, pp. 571–575. SCHNEIDER, E.C. AND A.M. EPSTEIN (1996), Influence of Cardiac-Surgery Performance Reports on Referral Practices and Access to Care. A Survey of Cardiovascular Specialists, in: New England Journal of Medicine, Vol. 335, pp. 251–256. SCHNEIDER, E.C. AND A.M. EPSTEIN (1998), Use of public performance reports: a survey of patients undergoing cardiac surgery, in: The Journal of the American Medical Association , Vol. 279, pp. 1638–1642. SCHWARTZ, L.M., WOLOSHIN, S. AND J.D. BIRKEMEYER (2005), How do elderly patients decide where to go for major surgery? Telephone interview survey, in: British Medical Journal, Vol. 331, p. 821. SICILIANI, L. AND S. MARTIN (2007), The Impact of Choice on Waiting Times, in: Health Economics, Vol. 16, pp. 763–779. TAI, W.C., F.W. PORELL AND E.K. ADAMS (2004), Hospital choice of rural Medicare bene-ficiaries: patient, hospital attributes, and the patient physician relationship, in: Health Services Research, Vol. 39, pp. 1903–1922. VARKEVISSER, M. AND S. VAN DER GEEST (2007), Why do patients bypass the nearest hos-pital? An empirical analysis for orthopaedics care and neurosurgery in the Neth-erlands, in: The European Journal of Health Economics, Vol. 8, pp. 287–295. WOOLDRIDGE, J.M. (2002), Econometric Analysis of Cross-Section and Panel Data, Cam-bridge. WEDIG, G.J. AND M. TAI-SEALE (2002), The Effect of Report Cards on Consumer Choice in the Health Insurance Market.”, in: Journal of Health Economics, Vol. 21, pp. 1031–1048. |
URI: | https://mpra.ub.uni-muenchen.de/id/eprint/10479 |