Effects of Competition under Prospective Payment on Hospital Costs among High and Low Cost Admissions: Evidence from California, 1983 - 1993

Meltzer, David O.; Chung, Jeanette W.

doi:10.3386/w8069

Cited by 4 publications

(1 citation statement)

References 35 publications

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“…A large literature documents hospitals' theoretical and empirical responses in introducing cost-saving or reimbursement-increasing measures under PPS. These measures include decreases in the length of stays [ 8 ], selective reductions in expenditures for high-cost patients [ 9 ], 'upcoding' - i.e. switching patients from appropriate lower-paying to higher-paying DRG in order to inflate reimbursement [ 10 ] and selection of profitable patients [ 11 ].…”

Section: The Role Of Health Insurance In the German Hospital Sectormentioning

confidence: 99%

The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data

Kuchinke¹,

Sauerland

Wübker

2009

Int J Equity Health

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BackgroundThere is an ongoing debate in Germany about the assumption that patients with private health insurance (PHI) benefit from better access to medical care, including shorter waiting times (Lüngen et al. 2008), compared to patients with statutory health insurance (SHI).ProblemExisting analyses of the determinants for waiting times in Germany are a) based on patient self-reports and b) do not cover the inpatient sector. This paper aims to fill both gaps by (i) generating new primary data and (ii) analyzing waiting times in German hospitals.MethodsWe requested individual appointments from 485 hospitals within an experimental study design, allowing us to analyze the impact of PHI versus SHI on waiting times (Asplin et al. 2005).ResultsIn German acute care hospitals patients with PHI have significantly shorter waiting times than patients with SHI.ConclusionDiscrimination in waiting times by insurance status does occur in the German acute hospital sector. Since there is very little transparency in treatment quality in Germany, we do not know whether discrimination in waiting times leads to discrimination in the quality of treatment. This is an important issue for future research.

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Section: The Role Of Health Insurance In the German Hospital Sectormentioning

confidence: 99%

The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data

Kuchinke¹,

Sauerland

Wübker

2009

Int J Equity Health

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Reimbursement schemes for hospitals, malpractice liability, and intrinsic motivation

Feess¹,

Ossig²

2007

International Review of Law and Economics

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Technological development and medical productivity: the diffusion of angioplasty in New York state

Cutler¹,

Huckman²

2003

Journal of Health Economics

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A puzzling feature of many medical innovations is that they simultaneously appear to reduce unit costs and increase total costs. We consider this phenomenon by examining the diffusion of percutaneous transluminal coronary angioplasty (PTCA)-a treatment for coronary artery diseaseover the past two decades. We find that growth in the use of PTCA led to higher total costs despite its lower unit cost. Over the two decades following PTCA's introduction, however, we find that the magnitude of this increase was reduced by between 10 and 20% due to the substitution of PTCA for CABG. In addition, the increased use of PTCA appears to be a productivity improvement. PTCAs that substitute for CABG cost less and have the same or better outcomes, while PTCAs that replace medical management appear to improve health by enough to justify the cost.

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Effects of Competition under Prospective Payment on Hospital Costs among High and Low Cost Admissions: Evidence from California, 1983 - 1993

Cited by 4 publications

References 35 publications

The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data

The influence of insurance status on waiting times in German acute care hospitals: an empirical analysis of new data

Reimbursement schemes for hospitals, malpractice liability, and intrinsic motivation

Technological development and medical productivity: the diffusion of angioplasty in New York state

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