Working Paper: NBER ID: w11707
Authors: Jason R. Barro; Robert S. Huckman; Daniel P. Kessler
Abstract: The recent rise of specialty hospitals -- typically for-profit firms that are at least partially owned by physicians -- has led to substantial debate about their effects on the cost and quality of care. Advocates of specialty hospitals claim they improve quality and lower cost; critics contend they concentrate on providing profitable procedures and attracting relatively healthy patients, leaving (predominantly nonprofit) general hospitals with a less-remunerative, sicker patient population. We find support for both sides of this debate. Markets experiencing entry by a cardiac specialty hospital have lower spending for cardiac care without significantly worse clinical outcomes. In markets with a specialty hospital, however, specialty hospitals tend to attract healthier patients and provide higher levels of intensive procedures than general hospitals.
Keywords: No keywords provided
JEL Codes: I1
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| lower growth in hospital expenditures (H51) | stable quality of care (I11) |
| Specialty hospital entry (I11) | selection effect (healthier patients) (I11) |
| Specialty hospitals provide intensive treatments of questionable cost-effectiveness (I11) | implications for social welfare (I38) |
| Specialty hospital entry (I11) | lower growth in hospital expenditures (H51) |