Quality of care information makes a difference - An analysis of market share and price changes after publication of the New York state cardiac surgery mortality reports
Quality of care information makes a difference - An analysis of market share and price changes after publication of the New York state cardiac surgery mortality reports
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DOI：
10.1097/00005650-199807000-00002
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发表时间：
1998-07-01
期刊：
影响因子：
3
通讯作者：
Mushlin, AI
中科院分区：
文献类型：
--
作者：
Mukamel, DB;Mushlin, AI
目标。高质量成绩单变得越来越普遍并受到广泛宣传。它们可以对医疗保健提供者之间的竞争、成本和质量产生重大影响。作者检验了这样的假设：《纽约州心脏手术报告》中报告结果较好的医院和外科医生的市场份额和价格相对增加。方法。纽约州心脏手术报告中的信息与医生向医疗保险提交的索赔相关联，并用于计算进行 CABG 手术的医院和医生的市场份额和平均价格，估计回归模型以检验假设。 1990-1993 年期间，对所有 30 家提供冠状动脉旁路移植术 (CABG) 的医院以及纽约州进行 CABG 手术的大多数外科医生（114 名或约 80%）进行了研究。结果。调查结果表明，效果更好的医院和医生的市场份额增长率更高。效果较好的医生在该手术中的费用增长率也较高。 结论：患者（和转诊医生）似乎对有关个体外科医生和医院质量的信息做出了预期的反应。报告的死亡率和市场份额之间的关联程度因地理位置而异，可能反映了社会人口特征的差异。这种关联往往会随着时间的推移而下降，这表明它主要是由于“新”信息造成的。
OBJECTIVES. Quality report cards are becoming increasingly more common and receive much publicity. They can have significant impact on competition among providers, costs, and quality of health care, The authors test the hypotheses that hospitals and surgeons with better outcomes reported in the NYS Cardiac Surgery Reports experience a relative increase in their market share and prices.METHODS. Information from the New York State Cardiac Surgery Reports was linked with physicians' claims submitted to Medicare and was used to calculate market shares and average prices for hospitals and physicians performing CABG surgeries, Regression models were estimated to test hypotheses. All 30 hospitals offering coronary artery bypass graft (CABG) were studied as well as a majority of surgeons (114 or approximately 80%) performing CABG surgery in New York State during the 1990-1993 period.RESULTS. Findings indicate that hospitals and physicians with better outcomes experienced higher rates of growth in market shares. Physicians with better outcomes also had higher rates of growth in charges for this procedure.CONCLUSIONS, Patients (and referring physicians) seem to respond to information about quality of individual surgeons and hospitals as expected. The magnitude of the association between reported mortality and market shares varies geographically, potentially reflecting differences in sociodemographic characteristics, The association tends to decline over time, suggesting that it is primarily due to "new" information.