Effect of nursing home ownership on the quality of post-acute care: An instrumental variables approach
Effect of nursing home ownership on the quality of post-acute care: An instrumental variables approach
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DOI：
10.1016/j.jhealeco.2012.08.007
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发表时间：
2013-01-01
影响因子：
3.5
通讯作者：
Mor, Vincent
中科院分区：
文献类型：
--
作者：
Grabowski, David C.;Feng, Zhanlian;Mor, Vincent
考虑到给予非营利机构的税收优惠待遇，政策制定者和研究人员一直对非营利机构提供的养老院质量是否高于营利性机构感兴趣。然而，对营利性和非营利性的差异选择可能导致对所有权形式影响的偏见估计。通过使用离最近的非营利性养老院相对于最近的营利性养老院的“差异距离”，我们模拟了在估计所有权对护理质量的影响时，居民或多或少“暴露”于非营利养老院的随机化。使用与医疗保险索赔相关的国家最低数据集评估，我们使用了在2004年1月1日至2005年6月30日的18个月内新入住养老院的急性后患者的国家队列。在确定所有权状态后，我们发现非营利性机构的急性后患者住院30天的时间更少，在活动能力、疼痛和功能方面有更大的改善。(C) 2012 Elsevier B.V.版权所有
Given the preferential tax treatment afforded nonprofit firms, policymakers and researchers have been interested in whether the nonprofit sector provides higher nursing home quality relative to its for-profit counterpart. However, differential selection into for-profits and nonprofits can lead to biased estimates of the effect of ownership form. By using "differential distance" to the nearest nonprofit nursing home relative to the nearest for-profit nursing home, we mimic randomization of residents into more or less "exposure" to nonprofit homes when estimating the effects of ownership on quality of care. Using national Minimum Data Set assessments linked with Medicare claims, we use a national cohort of post-acute patients who were newly admitted to nursing homes within an 18-month period spanning January 1, 2004 and June 30, 2005. After instrumenting for ownership status, we found that post-acute patients in nonprofit facilities had fewer 30-day hospitalizations and greater improvement in mobility, pain, and functioning. (C) 2012 Elsevier B.V. All rights reserved.