Long-Term Care Hospitals: A Case Study in Waste

• 成果类型: Article
• 署名作者: Einav, Liran; Finkelstein, Amy; Mahoney, Neale
• 署名单位: Stanford University; National Bureau of Economic Research; Massachusetts Institute of Technology (MIT)
• 刊物名称: REVIEW OF ECONOMICS AND STATISTICS
• ISSN/ISSBN: 0034-6535
• DOI: 10.1162/rest_a_01092
• 发表日期: 2023-07
• 页码: 745-765
• 关键词: financial incentives; UNITED-STATES; RISK; physicians; medicare; access

摘要

There is substantial waste in U.S. healthcare but little consensus on how to combat it. We identify one source of waste: long-term care hospitals (LTCHs). Using the entry of LTCHs into hospital markets in an event study design, we find that most LTCH patients would have counterfactually received care at Skilled Nursing Facilities-facilities that provide medically similar care but are paid significantly less-and that substitution to LTCHs leaves patients unaffected or worse off on all dimensions we can objectively measure. Our results imply Medicare could save about $4.6 billion per year by not allowing discharge to LTCHs.