HEALTH CARE MARKETS & QUALITY FOR THE VULNERABLE

该项目将使用AHCPR的医疗成本和利用项目(HCUP)的数据来研究医疗市场的变化如何影响向弱势群体提供的医院护理的质量，特别是少数族裔和未参保的人。具体地说，该项目将使用医院人口，特别是少数族裔和未参保的人。具体地说，该项目将使用州住院患者数据库(SID)中包括的13个州的医院出院数据来评估州住院患者数据库(SID)中所包含的13个州的出院数据的影响，以评估管理医疗和医院市场中的竞争对以下方面的影响：(1)医院提供的护理质量，重点是对安全网医院和非安全网医院的潜在差异影响；(2)按患者保险状况(例如，已投保与未投保)划分医院市场的程度。该项目将使用多元信号提取模型来从出院数据中构建医院质量的衡量标准。这些模型减少了数据中噪声的影响，结合了关于质量的多个维度的信息，并允许识别在携带质量信号方面最重要的维度。因此，除了分析目标外，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.