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Related Concept Videos

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Related Experiment Video

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
14:32

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Published on: February 16, 2011

Nursing Home Quality as a Common Good.

David C Grabowski1, Jonathan Gruber, Joseph J Angelelli

  • 1Harvard University.

The Review of Economics and Statistics
|September 28, 2011
PubMed
Summary

Nursing home quality is generally consistent for both Medicaid and private-pay residents within the same facility. This study confirms this long-standing economic assumption using detailed resident data across multiple states.

Area of Science:

  • Health Economics
  • Gerontology
  • Healthcare Management

Background:

  • A prevailing assumption in health economics posits uniform nursing home quality for all residents, irrespective of payment source (Medicaid vs. private pay).
  • Empirical evidence supporting this assumption has been notably scarce, prompting further investigation.

Purpose of the Study:

  • To empirically assess whether nursing home quality differs between Medicaid and private-pay residents within the same facility.
  • To examine the consistency of quality across payer types using robust analytical methods.

Main Methods:

  • Utilized a unique, individual-level panel dataset of nursing home residents from seven U.S. states.
  • Employed within-facility and within-person variation in payer source and quality metrics for identification.

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14:32

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  • Tested the robustness of findings across states with varying Medicaid and private-pay rate differentials.

    • Main Results:

    • Results consistently indicate that nursing home quality is common across both Medicaid and private-paying patients.
    • This finding held true across various identification strategies and different state contexts.
    • No significant disparities in quality were detected based on resident payer status within facilities.

    Conclusions:

    • The study provides strong empirical support for the assumption of uniform nursing home quality for all residents.
    • Findings suggest that payer source does not appear to be a determinant of quality within nursing home facilities.
    • Policy and economic models can proceed with greater confidence in the assumption of common quality across payer groups.