竞争与补偿对医院质量的影响是否因所有制类型而异?

IF 3.6 Q1 BUSINESS, FINANCE
Linda H. Chen, Leslie Eldenburg, Theodore H. Goodman
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引用次数: 0

摘要

目的本研究的目的是探讨两种驱动因素,即高管薪酬和市场竞争,如何影响美国的医院质量。最近,患者、保险公司和监管机构越来越关注医院的质量。了解该行业激励措施的相互作用很重要,因为在2019年,医院治疗为美国的医疗保健成本贡献了11.61亿美元。在所谓的“混合”行业中,所有权差异会影响组织目标和运营约束,本研究回应了对更多研究的呼吁。设计/方法/方法本研究探讨医院高管薪酬和行业竞争作为医疗保健质量决定因素的作用。具体而言,本研究探讨了影响美国医院类型质量的因素的异质性。研究结果利用2006年至2020年加州医院的数据,研究结果表明,薪酬和竞争对医院质量的影响因所有权类型而异。营利性医院的高管薪酬与质量正相关,而非营利性医院的高管薪酬与质量不相关,这表明营利性医院更有可能使用更高的薪酬水平来吸引能力更高的管理人员,而非营利性管理人员的效用函数可能是多维的。在非营利性医院集团中,相对于世俗非营利组织,竞争与宗教非营利组织的质量关系更为积极,这表明竞争为宗教医院提供了更多的监督。综上所述,这些发现提供了证据,表明不同医院的质量驱动因素各不相同,其方式与不同所有权类型的约束和目标的差异相一致。这些发现对寻求激励提高质量的监管机构很重要。例如,美国的医疗保险已将质量措施纳入其新的医院报销计划(基于价值的采购),以激励质量。本研究建议监管机构在评估激励医院质量的最佳方式时应考虑不同所有权类型的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does the influence of competition and compensation on hospital quality vary with ownership type?

Purpose

The purpose of this study is to investigate how two types of drivers, namely, executive compensation and market competition, can affect hospital quality in the USA. Recently, patients, insurers and regulators have increasingly focused on hospital quality. Understanding the interplay of incentives in this industry is important because in 2019, hospital treatment contributed $1.161bn to health-care costs in the USA. This study answers the call for more studies in the so-called “mixed” industry, where ownership differences can affect organizational objectives and operating constraints.

Design/methodology/approach

This study explores the roles of hospital executive compensation and industry competition as determinants of health-care quality. Specifically, the study probes the heterogeneity in the factors that influence quality across hospital types in the USA.

Findings

Using California hospital data from 2006 through 2020, the findings show that the effects of compensation and competition on hospital quality differ by ownership type. Executive compensation is positively associated with quality in for-profit hospitals but is not associated with that of nonprofit hospitals, suggesting for-profit hospitals are more likely to use higher levels of compensation to attract managers with higher ability, whereas the utility function for nonprofit managers may be multidimensional. Within the nonprofit hospital group, competition is more positively associated with quality for religious nonprofits relative to secular nonprofits, suggesting that competition provides more monitoring for religious hospitals.

Originality/value

Taken together, the findings provide evidence that the drivers of quality vary across hospitals in ways consistent with differences in constraints and objectives across ownership types. The findings are important for regulators seeking to incentivize higher quality. For example, Medicare in the USA has incorporated quality measures into its new hospital reimbursement scheme (value-based purchasing) to incentivize quality. This study proposes that regulators should consider differences across ownership types when evaluating the best ways to incentivize hospital quality.

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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
18
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