Start spreading the news: a structural estimate of the effects of New York hospital report cards.
Research on the effects of publicly reported hospital quality report cards on patient market shares is mixed. Higher-ranking hospitals do not consistently experience increases in market share. We argue that this may be because the report cards do not always convey "news" about quality; in some cases the rankings conform with prior beliefs about quality. We develop a structural model of the "news" in report cards and estimate the model using data from New York State in 1989-1991. We show hospitals with negative news in the original 1990 report cards experienced a decrease in market share, but that a misspecified model might continue to find no report card effect.
Dranove
David
D
Northwestern University, USA. d-dranove@kellogg.northwestern.edu
Sfekas
Andrew
A
D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D001499:Bayes Theorem; D002755:Choice Behavior; D001026:Coronary Artery Bypass / Q000592:standards* / Q000706:statistics & numerical data; D030881:Disclosure; D019981:Health Care Sector; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D033181:Information Dissemination; D007350:Insurance, Hospitalization; D008875:Middle Aged; D017059:Models, Econometric; D009341:Negativism; D009518:New York; D017060:Patient Satisfaction / Q000191:economics* / Q000208:ethnology; D011594:Psychometrics; D019984:Quality Indicators, Health Care / Q000145:classification* / Q000191:economics; D026712:Value of Life / Q000191:economics; D044465:White People / Q000523:psychology