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Managed Care Incentives and Inpatient Complications
Author(s) -
Haile Philip A.,
Stein Rebecca M.
Publication year - 2002
Publication title -
journal of economics and management strategy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.672
H-Index - 68
eISSN - 1530-9134
pISSN - 1058-6407
DOI - 10.1111/j.1430-9134.2002.00037.x
Subject(s) - managed care , incentive , medicine , variation (astronomy) , business , medical emergency , emergency medicine , health care , economics , physics , astrophysics , microeconomics , economic growth
Managed care organizations control costs through restrictions on patient access to specialized services, oversight of treatment protocols, and financial incentives for providers. We investigate possible effects of such practices on the care patients receive by studying frequencies of in‐hospital complications. We find significant differences in complication rates between managed care and fee‐for‐service patients. We investigate the sources of this variation by comparing probabilities of complications among patients with different types of managed care coverage and patients treated in different hospitals. For several patient categories, the differences in outcomes we find appear to arise not from differential treatment of patients within hospitals or from heterogeneity in patients, but from variations in care across hospitals that tend to treat patients with different insurance types.