Measuring Returns to Hospital Care: Evidence from Ambulance Referral Patterns

• 成果类型: Article
• 署名作者: Doyle, Joseph J., Jr.; Graves, John A.; Gruber, Jonathan; Kleiner, Samuel A.
• 署名单位: Massachusetts Institute of Technology (MIT); National Bureau of Economic Research; Vanderbilt University; Cornell University
• 刊物名称: JOURNAL OF POLITICAL ECONOMY
• ISSN/ISSBN: 0022-3808
• DOI: 10.1086/677756
• 发表日期: 2015
• 页码: 170-214
• 关键词: acute myocardial-infarction; health-care; regional-variations; geographic-variation; READMISSION RATES; MEDICARE PATIENTS; UNITED-STATES; outcomes; QUALITY; mortality

摘要

We consider whether hospitals that receive higher payments from Medicare improve patient outcomes, using exogenous variation in ambulance company assignment among patients who live near one another. Using Medicare data from 2002-10 on assignment across ambulance companies and New York State data from 2000-6 on assignment across area boundaries, we find that patients who are brought to higher-cost hospitals achieve better outcomes. Our estimates imply that a one standard deviation increase in Medicare reimbursement leads to a 4 percentage point (or 10 percent) reduction in mortality; the implied cost per at least 1 year of life saved is approximately $80,000.