Productivity and Quality in Health Care: Evidence from the Dialysis Industry

• Autores: Paul L. E. Grieco, Ryan C. McDevitt
• Localización: Review of economic studies, ISSN 0034-6527, Vol. 84, Nº 3, 2017, págs. 1071-1105
• Idioma: inglés
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• Resumen

  • We show that healthcare providers face a tradeoff between increasing the number of patients they treat and improving their quality of care. To measure the magnitude of this quality-quantity tradeoff, we estimate a model of dialysis provision that explicitly incorporates a centre’s unobservable and endogenous choice of treatment quality while allowing for unobserved differences in productivity across centres. We find that a centre that reduces its quality standards such that its expected rate of septic infections increases by 1 percentage point can increase its patient load by 1.6%, holding productivity, capital, and labour fixed; this corresponds to an elasticity of quantity with respect to quality of−0.2. Notably, our approach provides estimates of productivity that control for differences in quality, whereas traditional methods would misattribute lower-quality care to greater productivity