| Titre : | Can ranking hospitals on the basis of patients' travel distances improve quality of care ? |
| Titre original: | Classer les hôpitaux sur la base des distances d'accès hôpital/patients améliore-t-il la qualité des soins ? |
| Titre de série : | NBER Working Paper, n° 11419 |
| Auteurs : | D.P. KESSLER ; National Bureau of Economic Research. (N.B.E.R.). Cambridge CA. USA |
| Type de document : | Document de travail |
| Editeur : | Cambridge : N.B.E.R., 2005 |
| Format : | 30p., tabl., graph., fig. |
| Note générale : | Référence : réf. bibl. |
| Langues: | Anglais |
| Catégories : |
[BDSP5] Etablissement sanitaire > Caractéristique établissement [NI] > Classement établissement [BDSP5] Etablissement sanitaire > Structure curative > Hôpital [BDSP5] Etudes méthodes et statistiques [NI] > Méthodologie > Evaluation > Impact [BDSP5] Etudes méthodes et statistiques [NI] > Méthodologie > Processus > Amélioration [BDSP5] Géographie politique > Monde > Amérique > Amérique du Nord > Etats Unis [BDSP5] Pratique médicale > Relation soignant soigné > Relation médecin malade [BDSP5] Soins > Proximité soins [BDSP5] Soins > Qualité soins [BDSP5] Système soins > Accès soins [BDSP5] Système soins > Filière soins > Soins hospitaliers > Hospitalisation |
| Résumé : | Conventional outcomes report cards public disclosure of information about the patient background-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. |
| En ligne : | http://www.nber.org/papers/w11419.pdf |
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| Code-barres | Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|---|
| 0046696 | P193 | Document de travail | Documentation IRDES | P : périodiques | Disponible |