Evidence map›Paper›PMID 35872595›Full record

ArticleHealth services research2023

The effect of hospital discharge price increases on publicly reported measures of quality.

Daniel J Crespin, Christopher Whaley

Open access · greenAbstract read
In one paragraph

Article in Health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.1field-weighted citation impact, top 14% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Daniel J CrespinRAND Health Care, RAND Corporation, Boston, Massachusetts, USA.ORCID 0000-0002-2364-2052
Christopher WhaleyRAND Health Care, RAND Corporation, Santa Monica, California, USA.ORCID 0000-0002-9405-1989
RAND Corporation · US

Funding

The Effects of Insurance Benefit Design Innovation on Patient HealthK01AG061274 · NIA · RAND CORPORATION · PI WHALEY, CHRISTOPHER · 2019 to 2023
$649k
NIA NIH HHS K01 AG061274
6 · The paper itself

Abstract

objectiveTo determine if increases in hospital discharge prices are associated with improvements in clinical quality or patient experience. DATA SOURCES: This study used Medicare cost report data and publicly available Medicare.gov Care Compare quality measures for approximately 3000 short-term care general hospitals between 2011 and 2018. STUDY

designWe separately regressed quality measure scores on a lag of case mix adjusted discharge price, hospital fixed effects, and year indicators. Clinical quality measures included 30-day readmission rates for acute myocardial infarction, chronic obstructive pulmonary disease, heart failure, hip and knee replacement, and pneumonia; risk-adjusted 30-day mortality rates for acute myocardial infarction, chronic obstructive pulmonary disease, heart failure, and stroke; and 90-day complication rate for hip and knee replacement. Patient experience measures included the summary star rating and 10 domain measures reported through the Hospital Consumer Assessment of Healthcare Providers and Systems survey. We tested for heterogeneous effects by hospital ownership, number of beds, the commercial share of overall discharges, and market concentration. DATA COLLECTION/EXTRACTION

methodsWe linked hospitals identified in Medicare cost reports to Medicare.gov Care Compare quality measures. We excluded hospitals for which we could not identify a discharge price or that had an unrealistic price. PRINCIPAL

findingsThere was no positive association between lagged discharge price and any clinical quality measure. For patient experience measures, a 2% increase in discharge price was not associated with overall patient satisfaction but was associated with small, statistically significant increases ranging from 0.01% to 0.02% (relative to mean scores) for seven of ten domain measures. There was a positive association for five of ten patient experience measures in competitive markets and one measure in both moderately concentrated and heavily concentrated markets.

conclusionsWe found no evidence that hospitals use higher prices to make investments in clinical quality; patient experience improved, but only negligibly.

Indexed as

Heart FailureMyocardial InfarctionPulmonary Disease, Chronic ObstructiveAgedHumansMedicarePatient DischargePatient ReadmissionUnited Statesgeneral hospitalshealth carehospital chargespatient-reported outcome measuresquality indicatorsquality of health care

Identifiers

PMID35872595
PMCPMC9836939
OpenAlexW4287092473

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.