title: Modern Management Practices and Hospital Admissions.
abstract: We investigate whether the modern management practices and publicly reported performance measures are associated with choice of hospital for patients with acute myocardial infarction (AMI). We define and measure management practices at approximately half of US cardiac care units using a novel survey approach. A patient's choice of a hospital is modeled as a function of the hospital's performance on publicly reported quality measures and the quality of its management. The estimates, based on a grouped conditional logit specification, reveal that higher management scores and better performance on publicly reported quality measures are positively associated with hospital choice. Management practices appear to have a direct correlation with admissions for AMI--potentially through reputational effects--and indirect association, through better performance on publicly reported measures. Overall, a one standard deviation change in management practice scores is associated with an 8% increase in AMI admissions.
authors.affiliation: Oregon Health & Science University, Portland, OR, USA.
authors.forename: K John
authors.initials: KJ
authors.lastname: McConnell
authors.affiliation: University of Colorado at Denver, Aurora, CO, USA.
authors.forename: Richard C
authors.initials: RC
authors.lastname: Lindrooth
authors.affiliation: University of Minnesota, Minneapolis, MN, USA.
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Wholey
authors.affiliation: VA Eastern Colorado Health Care System/University of Colorado School of Medicine, Denver, CO, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Maddox
authors.affiliation: Stanford University, Stanford, CA, USA.
authors.forename: Nick
authors.initials: N
authors.lastname: Bloom
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002755:Choice Behavior; D003325:Coronary Care Units / Q000458:organization & administration* / Q000592:standards; D019538:Health Care Surveys; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D019221:Mandatory Reporting; D009203:Myocardial Infarction / Q000628:therapy*; D010343:Patient Admission / Q000706:statistics & numerical data*; D020399:Practice Management / Q000458:organization & administration / Q000592:standards*; D019984:Quality Indicators, Health Care; D014481:United States
keywords: hospital markets; hospital quality; management; public reporting