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Journal of Political Economy Vol. 111 No. 3 2003

Is More Information Better? The Effects of “Report Cards” on Health Care Providers

David Dranove1; Daniel P. Kessler2; Mark McClellan3; Mark Satterthwaite1

1 Northwestern University · 2 Stanford University · 3 Internal Medicine

Abstract

Health care report cards–public disclosure of patient health outcomes at the level of the individual physician and/or hospital–may address important informational asymmetries in markets for health care, but they may also give doctors and hospitals incentives to decline to treat more difficult, severely ill patients. Whether report cards are good for patients and for society depends on whether their Þnancial and health beneÞts outweigh their costs in terms of the quantity, quality, and appropriateness of medical treatment that they induce. Using national data on Medicare patients at risk for cardiac surgery, we Þnd that cardiac surgery report cards in New York and Pennsylvania led both to selection behavior by providers and to improved matching of patients with hospitals. On net, this led to higher levels of resource use and to worse health outcomes, particularly for sicker patients. We conclude that, at least in the short run, these report cards decreased patient and social welfare. 1

DOI
10.1086/374180
Volume
111
Issue
3
Pages
555-588
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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