Does better information about hospital quality affect patients’ choice? Empirical findings from Germany

Background: Economic theory strongly suggests that better information about the quality of care affects patients’ choice of health service providers. However, we have little empirical evidence about the impact of information provided on provider’s choice in Germany. Problem: In Germany, we recently find publicly available information about hospital quality. For example, 50 percent of the hospitals in the Rhine-Ruhr area do now publish their quality data voluntarily in a comprehensive, understandable and well prepared publication. Empirically, we see a strong demand for this publication. However, we do not have information so far, if – and how – this information affect patients’ choice of hospitals. Data and methodology: We take cross sectional time series data from more than 700.000 patients in the Rhine-Ruhr area and in the Cologne-Bonn area (control group) for the time period 2003 to 2006, i.e. 16 quarters. We examine whether the publication of quality information affects market shares and number of cases of the hospitals as well as travelling distance that patients accept to get to the hospital of their choice. In order to account for hospital-specific heterogeneity, we use fixed and random effects models. Results: First: Hospitals, which publish their quality data voluntarily, do attract more patients – compared to such hospital, that do not publish their quality data. Second: In the group of the publishing hospitals, hospitals with a higher than average quality slightly increased their market shares, whereas hospitals with a lower than average quality lost market shares. Conclusion: The provision of quality data has a significant impact on hospital choice: a higher quality leads to a higher demand. Based on these finding decision makers in hospitals have strong incentives (i) to make quality information publicly available and (ii) to keep their quality of care high.Keywords: Quality of care, Information, Hospital Choice JEL Classifications: I 12, C 33

On the Spectral Gap of Brownian Motion with Jump Boundary

In this paper we consider the Brownian motion with jump boundary and present a new proof of a recent result of Li, Leung and Rakesh concerning the exact convergence rate in the one-dimensional case. Our methods are different and mainly probabilistic relying on coupling methods adapted to the special situation under investigation. Moreover, we answer a question raised by Ben-Ari and Pinsky concerning the dependence of the spectral gap on the jump distribution in a multi-dimensional setting.Comment: 18 page

Does better information about hospital quality affect patients’ choice? Empirical findings from Germany

Background: Economic theory strongly suggests that better information about the quality of care affects patients’ choice of health service providers. However, we have little empirical evidence about the impact of information provided on provider’s choice in Germany. Problem: In Germany, we recently find publicly available information about hospital quality. For example, 50 percent of the hospitals in the Rhine-Ruhr area do now publish their quality data voluntarily in a comprehensive, understandable and well prepared publication. Empirically, we see a strong demand for this publication. However, we do not have information so far, if – and how – this information affect patients’ choice of hospitals. Data and methodology: We take cross sectional time series data from more than 700.000 patients in the Rhine-Ruhr area and in the Cologne-Bonn area (control group) for the time period 2003 to 2006, i.e. 16 quarters. We examine whether the publication of quality information affects market shares and number of cases of the hospitals as well as travelling distance that patients accept to get to the hospital of their choice. In order to account for hospital-specific heterogeneity, we use fixed and random effects models. Results: First: Hospitals, which publish their quality data voluntarily, do attract more patients – compared to such hospital, that do not publish their quality data. Second: In the group of the publishing hospitals, hospitals with a higher than average quality slightly increased their market shares, whereas hospitals with a lower than average quality lost market shares. Conclusion: The provision of quality data has a significant impact on hospital choice: a higher quality leads to a higher demand. Based on these finding decision makers in hospitals have strong incentives (i) to make quality information publicly available and (ii) to keep their quality of care high

Extremes of independent chi-square random vectors

We prove that the componentwise maximum of an i.i.d. triangular array of chi-square random vectors converges in distribution, under appropriate assumptions on the dependence within the vectors and after normalization, to the max-stable Hüsler-Reiss distribution. As a by-product we derive a conditional limit resul

Does better information about hospital quality affect patients’ choice? Empirical findings from Germany

Background: Economic theory strongly suggests that better information about the quality of care affects patients’ choice of health service providers. However, we have little empirical evidence about the impact of information provided on provider’s choice in Germany. Problem: In Germany, we recently find publicly available information about hospital quality. For example, 50 percent of the hospitals in the Rhine-Ruhr area do now publish their quality data voluntarily in a comprehensive, understandable and well prepared publication. Empirically, we see a strong demand for this publication. However, we do not have information so far, if – and how – this information affect patients’ choice of hospitals. Data and methodology: We take cross sectional time series data from more than 700.000 patients in the Rhine-Ruhr area and in the Cologne-Bonn area (control group) for the time period 2003 to 2006, i.e. 16 quarters. We examine whether the publication of quality information affects market shares and number of cases of the hospitals as well as travelling distance that patients accept to get to the hospital of their choice. In order to account for hospital-specific heterogeneity, we use fixed and random effects models. Results: First: Hospitals, which publish their quality data voluntarily, do attract more patients – compared to such hospital, that do not publish their quality data. Second: In the group of the publishing hospitals, hospitals with a higher than average quality slightly increased their market shares, whereas hospitals with a lower than average quality lost market shares. Conclusion: The provision of quality data has a significant impact on hospital choice: a higher quality leads to a higher demand. Based on these finding decision makers in hospitals have strong incentives (i) to make quality information publicly available and (ii) to keep their quality of care high

L^2-spectral-theory for Markov operators

Wir betrachten Markov-Operatoren induziert durch Markov-Ketten mit beliebigem Zustandsraum auf bestimmten L2-Räumen. Die Frage nach der Existenz einer L2-Spektrallücke ist dabei wesentlich. Die Analyse erfolgt dabei auf drei Wegen. Der erste basiert auf eine Arbeit von Lawler und Sokal. Hierauf aufbauend definieren wir eine Familie von Konstanten, um mit ihrer Hilfe hinreichende und notwendige Kriterien für die Existenz von Spektrallücken zu bekommen. Im Falle reversibler bzw. schwach reversibler Ketten vereinfachen sich diese Bedingungen sehr. Der zweite Zugang basiert auf dem Begriff der Entropie, insbesondere dem des Entropiezuwachses. Wir geben zwei unterschiedliche Wachstumgsbegriffe an, aus denen wiederum hinreichende und notwendige Bedingungen für die Existenz von L2-Spektrallücken hergeleitet werden. Schließlich wird der Zusammenhang von f.s. geometrischer Ergodizität und L2-Spektrallücken untersucht und neue Resultate für den nicht reversiblen Fall erzielt. Zusätzlich beweisen wir einen neuen globalen Grenzwertsatz für eine Folge von Zufallsvariablen induziert durch Markov-Ketten im Falle einer nicht normalen, \alpha-stablilen Grenzverteilung

Beeinflussen bessere Qualitätsinformationen die Krankenhauswahl in Deutschland?

This paper examines, whether well prepared report cards affect hospital choice within Germany. We report three main findings. First, hospitals, which publish their quality data voluntarily, extend their market shares after relative to before publishing the quality data – compared to such hospitals that do not publish their quality data. Second: In the group of the publishing hospitals, hospitals with a higher than average quality increased their market shares after relative to before the adoption of the report card compared to hospitals with a lower than average quality. Third: Hospitals with quality below average are basically chosen by patients living nearby and not by those with a higher travelling distance. Based on these finding decision makers in hospitals have strong incentives (i) to make quality information publicly available and (ii) to keep their quality scores high.Quality of care, report cards, consumer choice, panel data