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Can We Measure Hospital Quality from Physicians' Choices?

Author

Listed:
  • Machado, Matilde
  • Mora, Ricardo
  • Romero-Medina, Antonio
Abstract
In this paper, we propose an alternative methodology for ranking hospitals based on the choices of Medical School graduates over hospital training vacancies. Our methodology is therefore a revealed preference approach. Our methodology for measuring relative hospital quality has the following desirable properties: a) robust to manipulation from hospital administrators; b) conditional on having enough observations, it allows for differences in quality across specialties within a hospital; c) inexpensive in terms of data requirements, d) not subject to selection bias from patients nor hospital screening of patients; and e) unlike other rankings based on experts' evaluations, it does not require physicians to provide a complete ranking of all hospitals. We apply our methodology to the Spanish case and find, among other results, the following: First, the probability of choosing the best hospital relative to the worst hospital is statistically significantly different from zero. Second, physicians value proximity and nearby hospitals are seen as more substitutable. Third, observable time-invariant city characteristics are unrelated to results. Finally, our estimates for physicians' hospital valuations are significantly correlated to more traditional hospital quality measures.

Suggested Citation

  • Machado, Matilde & Mora, Ricardo & Romero-Medina, Antonio, 2008. "Can We Measure Hospital Quality from Physicians' Choices?," CEPR Discussion Papers 6850, C.E.P.R. Discussion Papers.
    • Handle: RePEc:cpr:ceprdp:6850
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    Cited by:

    1. Ran I. Shorrer & Sandor Sovago, 2017. "Obvious Mistakes in a Strategically Simple College Admissions Environment," Tinbergen Institute Discussion Papers 17-107/V, Tinbergen Institute.
    2. Jeffrey E. Harris & Beatriz G. López-Valcárcel & Patricia Barber & Vicente Ortún, 2014. "Efficiency versus Equity in the Allocation of Medical Specialty Training Positions in Spain: A Health Policy Simulation Based on a Discrete Choice Model," NBER Working Papers 19896, National Bureau of Economic Research, Inc.
    3. Csató, László, 2013. "Rangsorolás páros összehasonlításokkal. Kiegészítések a felvételizői preferencia-sorrendek módszertanához [Paired comparisons ranking. A supplement to the methodology of application-based preferenc," Közgazdasági Szemle (Economic Review - monthly of the Hungarian Academy of Sciences), Közgazdasági Szemle Alapítvány (Economic Review Foundation), vol. 0(12), pages 1333-1353.
    4. Alcalde, José, 2018. "Beyond the Spanish MIR with consent: (Hidden) cooperation and coordination in matching," Games and Economic Behavior, Elsevier, vol. 110(C), pages 32-49.

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    More about this item

    Keywords

    Hospital quality; Hospital rankings; Nested logit; Physicians' labour market; Revealed preference;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations

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