title: Response to regulatory stringency: the case of antipsychotic medication use in nursing homes.
abstract: This paper studies the impact of regulatory stringency, as measured by the statewide deficiency citation rate over the past year, on the quality of care provided in a national sample of nursing homes from 2000 to 2005. The quality measure used is the proportion of residents who are using antipsychotic medication. Although the changing case-mix of nursing home residents accounts for some of the increase in the use of antipsychotics, we find that the use of antipsychotics by nursing homes is responsive to state regulatory enforcement in a manner consistent with the multitasking incentive problem. Specifically, the effect of the regulations is dependent on the degree of complementarity between the regulatory deficiency and the use of antipsychotics.
authors: Department of Economics and Scripps Gerontology Center, Miami University, Oxford, OH 45056, USA. jbowblis@muohio.edu
authors: John R
authors: JR
authors: Bowblis
authors: Stephen
authors: S
authors: Crystal
authors: Orna
authors: O
authors: Intrator
authors: Judith A
authors: JA
authors: Lucas
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage*; D003953:Diagnosis-Related Groups; D004363:Drug Utilization; D033161:Government Regulation; D006707:Homes for the Aged / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D008483:Medical Assistance / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy; D009735:Nursing Homes / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D009740:Nursing Staff / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000331:legislation & jurisprudence; D012149:Restraint, Physical / Q000706:statistics & numerical data; D013219:State Government
chemical_list: D014150:Antipsychotic Agents