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Related Experiment Videos

Quality and provider choice: a multinomial logit-least-squares model with selectivity.

D Haas-Wilson1, E Savoca

  • 1Department of Economics, Smith College, Northampton, MA 01063.

Health Services Research
|February 1, 1990
PubMed
Summary

Consumer choice of contact lens providers is influenced by regulations and licensing. Not controlling for selection bias can overestimate the quality of care from ophthalmologists.

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Area of Science:

  • Health Economics
  • Consumer Behavior
  • Ophthalmology

Background:

  • Understanding consumer choice in healthcare is crucial for policy.
  • Quality of care measurement in the contact lens industry requires robust methods.

Purpose of the Study:

  • To model the joint determination of provider choice and quality of care for contact lenses.
  • To analyze the impact of regulations on consumer choice among opticians, ophthalmologists, and optometrists.
  • To assess quality of care using an outcome-based measure and control for selection bias.

Main Methods:

  • Utilized a Federal Trade Commission survey of contact lens wearers.
  • Estimated a multinomial logit-least-squares model.
  • Measured quality of care as an index of pathological eye conditions from poorly fitted lenses.

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  • Controlled for selection bias in provider choice and quality of care.

    • Main Results:

    • Professional regulations limiting optometrist commercial practices shift demand towards ophthalmologists.
    • Optician licensing requirements increase consumer choice of opticians for lens fitting.
    • A significant positive selection bias was found for ophthalmologist services, inflating perceived quality.

    Conclusions:

    • Regulatory and licensing policies demonstrably influence consumer choice in the contact lens market.
    • Failure to account for selection bias leads to inaccurate assessments of ophthalmologist quality of care.
    • Outcome-based quality measures, when adjusted for selection bias, provide a more accurate evaluation of healthcare services.