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The Effects of Hospital Competition on Inpatient Quality of Care.

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Title: The Effects of Hospital Competition on Inpatient Quality of Care.
Authors: Mutter, Ryan L.1 Ryan.Mutter@ahrq.hhs.gov, Wong, Herbert S.1, Goldfarb, Marsha G.2
Source: Inquiry (00469580). Fall2008, Vol. 45 Issue 3, p263-279. 17p. 4 Charts.
Subject Terms: Medical care, Inpatient care, Caring, Estimation theory, Economic competition, Regression (Psychology), Medical care costs, Hospitals, Databases
Abstract: Existing empirical studies have produced inconclusive, and sometimes contradictory, findings on the effects of hospital competition on inpatient quality of care. These inconsistencies may be due to the use of different methodologies, hospital competition measures, and hospital quality measures. This paper applies the Quality Indicator software from the Agency for Healthcare Research and Quality to the 1997 Healthcare Cost and Utilization Project State Inpatient Databases to create three versions (i.e., observed, risk-adjusted, and "smoothed") of 38 distinct measures of inpatient quality. The relationship between 12 different hospital competition measures and these quality measures are assessed, using ordinary least squares, two-step efficient generalized method of moments, and negative binomial regression techniques. We find that across estimation strategies, hospital competition has an impact on a number of hospital quality measures. However, the effect is not unidirectional: some indicators show improvements in hospital quality with greater levels of competition, some show decreases in hospital quality, and others are unaffected. We provide hypotheses based on emerging areas of research that could explain these findings, but inconsistencies remain. [ABSTRACT FROM AUTHOR]
Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: The Effects of Hospital Competition on Inpatient Quality of Care.
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  Data: <searchLink fieldCode="JN" term="%22Inquiry+%2800469580%29%22">Inquiry (00469580)</searchLink>. Fall2008, Vol. 45 Issue 3, p263-279. 17p. 4 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Medical+care%22">Medical care</searchLink><br /><searchLink fieldCode="DE" term="%22Inpatient+care%22">Inpatient care</searchLink><br /><searchLink fieldCode="DE" term="%22Caring%22">Caring</searchLink><br /><searchLink fieldCode="DE" term="%22Estimation+theory%22">Estimation theory</searchLink><br /><searchLink fieldCode="DE" term="%22Economic+competition%22">Economic competition</searchLink><br /><searchLink fieldCode="DE" term="%22Regression+%28Psychology%29%22">Regression (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+costs%22">Medical care costs</searchLink><br /><searchLink fieldCode="DE" term="%22Hospitals%22">Hospitals</searchLink><br /><searchLink fieldCode="DE" term="%22Databases%22">Databases</searchLink>
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  Data: Existing empirical studies have produced inconclusive, and sometimes contradictory, findings on the effects of hospital competition on inpatient quality of care. These inconsistencies may be due to the use of different methodologies, hospital competition measures, and hospital quality measures. This paper applies the Quality Indicator software from the Agency for Healthcare Research and Quality to the 1997 Healthcare Cost and Utilization Project State Inpatient Databases to create three versions (i.e., observed, risk-adjusted, and "smoothed") of 38 distinct measures of inpatient quality. The relationship between 12 different hospital competition measures and these quality measures are assessed, using ordinary least squares, two-step efficient generalized method of moments, and negative binomial regression techniques. We find that across estimation strategies, hospital competition has an impact on a number of hospital quality measures. However, the effect is not unidirectional: some indicators show improvements in hospital quality with greater levels of competition, some show decreases in hospital quality, and others are unaffected. We provide hypotheses based on emerging areas of research that could explain these findings, but inconsistencies remain. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.5034/inquiryjrnl_45.03.263
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      – Code: eng
        Text: English
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        PageCount: 17
        StartPage: 263
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      – SubjectFull: Medical care
        Type: general
      – SubjectFull: Inpatient care
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      – SubjectFull: Caring
        Type: general
      – SubjectFull: Estimation theory
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      – SubjectFull: Economic competition
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      – SubjectFull: Medical care costs
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      – SubjectFull: Hospitals
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      – SubjectFull: Databases
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      – TitleFull: The Effects of Hospital Competition on Inpatient Quality of Care.
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              Text: Fall2008
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