Abstract
Mortality rates are a widely used measure of hospital quality. A central problem with this measure is selection bias: simply put, severely ill patients may choose high quality hospitals. We control for severity of illness with an instrumental variables (IV) framework using geographic location data. We use IV to examine the quality of pneumonia care in Southern California from 1989 to 1994. We find that the IV quality estimates are markedly different from traditional GLS estimates, and that IV reveals different determinants of quality. Econometric tests suggest that the IV model is appropriately specified, that the GLS model is inconsistent. Copyright (C) 1999 Elsevier Science B.V.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 747-767 |
| Number of pages | 21 |
| Journal | Journal of Health Economics |
| Volume | 18 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 1999 |
| Externally published | Yes |
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Keywords
- Hospital
- Instrumental variables
- Mortality
- Quality
ASJC Scopus subject areas
- Economics and Econometrics
Cite this
Estimating the quality of care in hospitals using instrumental variables. / Gowrisankaran, Gautam; Town, Robert J.
In: Journal of Health Economics, Vol. 18, No. 6, 12.1999, p. 747-767.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Estimating the quality of care in hospitals using instrumental variables
AU - Gowrisankaran, Gautam
AU - Town, Robert J.
PY - 1999/12
Y1 - 1999/12
N2 - Mortality rates are a widely used measure of hospital quality. A central problem with this measure is selection bias: simply put, severely ill patients may choose high quality hospitals. We control for severity of illness with an instrumental variables (IV) framework using geographic location data. We use IV to examine the quality of pneumonia care in Southern California from 1989 to 1994. We find that the IV quality estimates are markedly different from traditional GLS estimates, and that IV reveals different determinants of quality. Econometric tests suggest that the IV model is appropriately specified, that the GLS model is inconsistent. Copyright (C) 1999 Elsevier Science B.V.
AB - Mortality rates are a widely used measure of hospital quality. A central problem with this measure is selection bias: simply put, severely ill patients may choose high quality hospitals. We control for severity of illness with an instrumental variables (IV) framework using geographic location data. We use IV to examine the quality of pneumonia care in Southern California from 1989 to 1994. We find that the IV quality estimates are markedly different from traditional GLS estimates, and that IV reveals different determinants of quality. Econometric tests suggest that the IV model is appropriately specified, that the GLS model is inconsistent. Copyright (C) 1999 Elsevier Science B.V.
KW - Hospital
KW - Instrumental variables
KW - Mortality
KW - Quality
UR - http://www.scopus.com/inward/record.url?scp=0032735248&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032735248&partnerID=8YFLogxK
U2 - 10.1016/S0167-6296(99)00022-3
DO - 10.1016/S0167-6296(99)00022-3
M3 - Article
C2 - 10847933
AN - SCOPUS:0032735248
VL - 18
SP - 747
EP - 767
JO - Journal of Health Economics
JF - Journal of Health Economics
SN - 0167-6296
IS - 6
ER -