Kaestner Robert, Guardado Jose
Department of Economics and Institute of Government and Public Affairs, University of Illinois at Chicago, 815 West Van Buren Street, Chicago, IL 60607, USA.
J Health Econ. 2008 Mar;27(2):339-61. doi: 10.1016/j.jhealeco.2007.04.003. Epub 2007 Nov 29.
There is widespread concern about the quality of health care in the US, and the effect of provider payments on the quality of care is an important and unsettled issue in this debate. The critical question is whether changes in provider payments affect health. To date there is relatively little research on this question. Here, we present evidence of the effect of plausibly exogenous changes in Medicare reimbursement--caused by geographical reclassification--on hospital staffing (nurses) and patient outcomes. We find that changes in Medicare reimbursement levels of approximately 10% have no meaningful effect on hospital use of resources or patient outcomes.
美国医疗保健质量受到广泛关注，而医疗服务提供者薪酬对医疗质量的影响是这场辩论中一个重要且尚未解决的问题。关键问题在于医疗服务提供者薪酬的变化是否会影响健康状况。迄今为止，关于这个问题的研究相对较少。在此，我们展示了由地理重新分类导致的医疗保险报销中看似外生的变化对医院人员配备（护士）和患者结局影响的证据。我们发现，医疗保险报销水平约10%的变化对医院资源使用或患者结局没有显著影响。
