Can competition improve hospital quality of care? A difference-in-differences approach to evaluate the effect of increasing quality transparency on hospital quality

Item Type Journal paper
Abstract

Public reporting on the quality of care is intended to guide patients to the provider with the highest quality and to stimulate a fair competition on quality. We apply a difference-in-differences design to test whether hospital quality has improved more in markets that are more competitive after the first public release of performance data in Germany in 2008. Panel data from 947 hospitals from 2006 to 2010 are used. Due to the high complexity of the treatment of stroke patients, we approximate general hospital quality by the 30-day risk-adjusted mortality rate for stroke treatment. Market structure is measured (comparatively) by the Herfindahl–Hirschman index (HHI) and by the number of hospitals in the relevant market. Predicted market shares based on exogenous variables only are used to compute the HHI to allow a causal interpretation of the reform effect. A homogenous positive effect of competition on quality of care is found. This effect is mainly driven by the response of non-profit hospitals that have a narrow range of services and private for-profit hospitals with a medium range of services. The results highlight the relevance of outcome transparency to enhance hospital quality competition.

Authors Strumann, Christoph; Geissler, Alexander; Busse, Reinhard & Pross, Christoph
Journal or Publication Title The European Journal of Health Economics
Language English
Subjects health sciences
HSG Classification contribution to scientific community
Refereed Yes
Date 8 January 2022
Publisher Springer Nature Switzerland AG
Number of Pages 14
ISSN-Digital 1618-7601
Publisher DOI https://doi.org/10.1007/s10198-021-01423-9
Official URL https://link.springer.com/article/10.1007/s10198-0...
Contact Email Address alexander.geissler@unisg.ch
Depositing User Anita Koller
Date Deposited 12 Jan 2022 14:20
Last Modified 12 Jan 2022 14:39
URI: https://www.alexandria.unisg.ch/publications/265599

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Citation

Strumann, Christoph; Geissler, Alexander; Busse, Reinhard & Pross, Christoph (2022) Can competition improve hospital quality of care? A difference-in-differences approach to evaluate the effect of increasing quality transparency on hospital quality. The European Journal of Health Economics,

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https://www.alexandria.unisg.ch/id/eprint/265599
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