HEALTH CARE MARKETS & QUALITY FOR THE VULNERABLE

该项目将使用AHCPR的医疗保健成本和利用项目（HCUP）的数据，研究医疗保健市场的变化如何影响向弱势群体，特别是少数民族和无保险人群提供的医院护理的质量。具体来说，该项目将利用医院人口，特别是少数民族和没有保险的人。具体而言，该项目将使用纳入国家住院病人数据库（SID）的13个州的出院数据来评估纳入国家住院病人数据库（SID）的13个州的出院数据的影响，以评估管理式护理和医院市场竞争的影响：(1)医院提供的护理质量，重点关注对安全网医院和非安全网医院的潜在差异影响；(2)医院市场按患者保险状况划分的程度（例如，有保险与无保险）。本项目将利用多变量信号提取模型从出院数据中构建医院质量测度。这些模型减少了数据中噪声的影响，结合了质量的多个维度的信息，并允许识别在承载质量信号时最重要的经验维度。因此，除了分析目标之外，该项目还将在使用出院数据衡量医院质量方面进行重要的方法创新。

This project will use data from the AHCPR's Healthcare Cost and Utilization Project (HCUP) to study how changes in health care markets have affected the quality of hospital care provided to vulnerable populations, especially minorities and the uninsured. Specifically, the project will use hospital populations, especially, especially minorities and the uninsured. Specifically, the project will use hospital discharge data for 13 states included in the State Inpatient Database (SID) to assess the effects of discharge data for 13 states include in the State Inpatient Database (SID) to assess the effects of competition in the managed care and hospital markets on: (1) the quality of care provided by hospitals focusing on potential differential effects for safety net and non safety net hospitals, (2) the degree of segmentation in hospital markets by patient insurance status (e.g, insured vs. uninsured). The project will use multivariate signal extraction models to construct the measures of hospital quality from form the discharge data. These models reduce the effect of noise in the data, incorporate information on multiple dimensions of quality, and permit identification of the dimensions that are most important empirically in carrying the quality signal. Therefore, in addition to its analytic goals, the project will make important methodological innovations in the use of discharge data to measure hospital quality.