Kunz Johannes S, Propper Carol
Monash University, Monash Business School, 900 Dandenong Road, 3145 Caulfield East, Vic, Australia.
Imperial College London, Department of Economics and Public Policy, South Kensington Campus, SW1A 2AZ United Kingdom.
J Urban Econ. 2023 Jan;133:103472. doi: 10.1016/j.jue.2022.103472. Epub 2022 Jun 23.
In the large literature on the spatial-level correlates of COVID-19, the association between quality of hospital care and outcomes has received little attention to date. To examine whether county-level mortality is correlated with measures of hospital performance, we assess daily cumulative deaths and pre-crisis measures of hospital quality, accounting for state fixed-effects and potential confounders. As a measure of quality, we use the pre-pandemic adjusted five-year penalty rates for excess 30-day readmissions following pneumonia admissions for the hospitals accessible to county residents based on ambulance travel patterns. Our adjustment corrects for socio-economic status and down-weighs observations based on small samples. We find that a one-standard-deviation increase in the quality of local hospitals is associated with a 2% lower death rate (relative to the mean of 20 deaths per 10,000 people) one and a half years after the first recorded death.
在关于新冠疫情空间层面关联因素的大量文献中，医院护理质量与治疗结果之间的关联至今很少受到关注。为了研究县级死亡率是否与医院绩效指标相关，我们评估了每日累计死亡人数以及危机前的医院质量指标，同时考虑了州固定效应和潜在混杂因素。作为质量衡量指标，我们根据救护车行驶模式，使用县居民可及医院肺炎入院后30天再入院超额情况的疫情前调整后五年惩罚率。我们的调整校正了社会经济地位，并基于小样本对观测值进行了加权下调。我们发现，当地医院质量提高一个标准差，在首次记录死亡事件一年半后，死亡率会降低2%（相对于每万人20例死亡的均值）。
