Access

You are not currently logged in.

Access JSTOR through your library or other institution:

login

Log in through your institution.

If You Use a Screen Reader

This content is available through Read Online (Free) program, which relies on page scans. Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.

The Incidence of Adverse Medical Outcomes Under Prospective Payment

David M. Cutler
Econometrica
Vol. 63, No. 1 (Jan., 1995), pp. 29-50
Published by: The Econometric Society
DOI: 10.2307/2951696
Stable URL: http://www.jstor.org/stable/2951696
Page Count: 22
  • Read Online (Free)
  • Download ($10.00)
  • Subscribe ($19.50)
  • Cite this Item
Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
The Incidence of Adverse Medical Outcomes Under Prospective Payment
Preview not available

Abstract

This paper examines the effect of prospective payment for hospital care on adverse medical outcomes. In 1983, the federal government replaced its previous cost-based reimbursement method with a Prospective Payment System, under which reimbursement depends only on the diagnosis of the patient. Hospitals thus lost the marginal reimbursement they formerly received for providing additional treatments. In addition, the average price each hospital received for patients with different diagnoses changed. This paper relates each of these changes to adverse outcomes, with two conclusions. First, there is a change in the timing of deaths associated with changes in average prices. In hospitals with price declines, a greater share of deaths occur in the hospital or shortly after discharge, but by one year post-discharge, mortality is no higher. Second, there is a trend increase in readmission rates caused by the elimination of marginal reimbursement. This appears to be due to accounting changes on the part of hospitals, however, rather than true changes in morbidity.

Page Thumbnails

  • Thumbnail: Page 
29
    29
  • Thumbnail: Page 
30
    30
  • Thumbnail: Page 
31
    31
  • Thumbnail: Page 
32
    32
  • Thumbnail: Page 
33
    33
  • Thumbnail: Page 
34
    34
  • Thumbnail: Page 
35
    35
  • Thumbnail: Page 
36
    36
  • Thumbnail: Page 
37
    37
  • Thumbnail: Page 
38
    38
  • Thumbnail: Page 
39
    39
  • Thumbnail: Page 
40
    40
  • Thumbnail: Page 
41
    41
  • Thumbnail: Page 
42
    42
  • Thumbnail: Page 
43
    43
  • Thumbnail: Page 
44
    44
  • Thumbnail: Page 
45
    45
  • Thumbnail: Page 
46
    46
  • Thumbnail: Page 
47
    47
  • Thumbnail: Page 
48
    48
  • Thumbnail: Page 
49
    49
  • Thumbnail: Page 
50
    50