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J Health Econ. 2014 Mar;34:42-58. doi: 10.1016/j.jhealeco.2013.12.004. Epub 2014 Jan 8.

Competition and the impact of online hospital report cards.

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Department of Economics, Lehigh University and National Bureau of Economic Research, United States. Electronic address:
Department of Economics, Lehigh University, United States. Electronic address:
Department of Health Policy, School of Public Health and Health Services, The George Washington University, United States. Electronic address:
Health Services Administration, Graduate Program, College of Health Sciences, Barry University, United States. Electronic address:


Information on the quality of healthcare gives providers an incentive to improve care, and this incentive should be stronger in more competitive markets. We examine this hypothesis by studying Pennsylvanian hospitals during the years 1995-2004 to see whether those hospitals located in more competitive markets increased the quality of the care provided to Medicare patients after report cards rating the quality of their Coronary Artery Bypass Graft programs went online in 1998. We find that after the report cards went online, hospitals in more competitive markets used more resources per patient, and achieved lower mortality among more severely ill patients.


CABG report cards; Health outcomes; Hospital competition; Predicted HHIs; Quality information

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