ArticleHealth services research2010
Effects of competition on the cost and quality of inpatient rehabilitation care under prospective payment.
Article in Health services research, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Postacute Care Setting, Facility Characteristics, and Poststroke Outcomes: A Systematic Review.Archives of physical medicine and rehabilitation · 2018Pooled it
- Influence of social determinants of health on post-acute use and outcome: a scoping review.Health affairs scholar · 2026Review
- Regional variation in length of stay for stroke inpatient rehabilitation in traditional Medicare and Medicare Advantage.Health affairs scholar · 2024Article
- Heterogeneous effects of hospital competition on inpatient quality: an analysis of five common diseases in China.Health economics review · 2024Article
- Changes in Use of Postacute Care Associated With Accountable Care Organizations in Hip Fracture, Stroke, and Pneumonia Hospitalized Cohorts.Medical care · 2019Article
- Thirty-day readmission and mortality among Medicare beneficiaries discharged to skilled nursing facilities after vascular surgery.The Journal of surgical research · 2018Article
- Competition and quality in a physiotherapy market with fixed prices.The European journal of health economics : HEPAC : health economics in prevention and care · 2017Article
- Payment reform. Introduction.Health services research · 2010Article
- Changes in Payment Regulation and Acute Care Use for Total Hip Replacement: Trends in Length of Stay, Costs, and Discharge, 1997-2012.Rehabilitation nursing : the official journal of the Association of Rehabilitation NursesArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo determine the effect of competition in postacute care (PAC) markets on resource intensity and outcomes of care in inpatient rehabilitation facilities (IRFs) after prospective payment was implemented. DATA SOURCES: Medicare claims, Provider of Services file, Enrollment file, Area Resource file, Minimum Data Set. STUDY
designWe created an exogenous measure of competition based on patient travel distances and used instrumental variables models to estimate the effect of competition on inpatient rehabilitation costs, length of stay, and death or institutionalization. DATA EXTRACTION
methodsA file was constructed linking data for Medicare patients discharged from acute care between 2002 and 2003 and admitted to an IRF with a diagnosis of hip fracture or stroke. PRINCIPAL
findingsCompetition had different effects on treatment intensity and outcomes for hip fracture and stroke patients. In the treatment of hip fracture, competition increased costs and length of stay, while increasing rates of death or institutionalization. In the treatment of stroke, competition decreased costs and length of stay and produced inferior outcomes.
conclusionsThe effects of competition in PAC markets may vary by condition. It is important to study the effects of competition by diagnostic condition and to study the effects across populations that vary in severity. Our finding that higher competition under prospective payment led to worse IRF outcomes raises concerns and calls for additional research.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.