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@techreport{NBERw11419,
 title = "Can Ranking Hospitals on the Basis of Patients' Travel Distances Improve Quality of Care?",
 author = "Kessler, Daniel P",
 institution = "National Bureau of Economic Research",
 type = "Working Paper",
 series = "Working Paper Series",
 number = "11419",
 year = "2005",
 month = "June",
 doi = {10.3386/w11419},
 URL = "http://www.nber.org/papers/w11419",
 abstract = {Conventional outcomes report cards-- public disclosure of information about the patient-background-adjusted health outcomes of individual hospitals and physicians -- may help improve quality, but they may also encourage providers to "game" the system by avoiding sick and/or seeking healthy patients.  In this paper, I propose an alternative approach:  ranking hospitals on the basis of the travel distances of their Medicare patients.  At least in theory, a distance report card could dominate conventional outcomes report cards:  a distance report card might measure quality of care at least as well but suffer less from selection problems.  I use data on elderly Medicare beneficiaries with heart attack and stroke from 1994 and 1999 to show that a distance report card would be both valid -- that is, correlated with true quality -- and able to distinguish confidently among hospitals -- that is, able to reject at conventional significance levels the hypothesis that the true quality of a low-ranked hospital was the same as the quality of the average hospital.  The hypothetical distance report card I propose compares favorably to (although does not necessarily dominate) the California AMI outcomes report card.},
}