TY  - JOUR
AU  - Almond,Douglas
AU  - Currie,Janet
AU  - Simeonova,Emilia
TI  - Public vs. Private Provision of Charity Care? Evidence from the Expiration of Hill-Burton Requirements in Florida
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 15798
PY  - 2010
Y2  - March 2010
UR  - http://www.nber.org/papers/w15798
L1  - http://www.nber.org/papers/w15798.pdf
N1  - Author contact info:
Douglas Almond
Department of Economics
Columbia University
International Affairs Building, MC 3308
420 West 118th Street
New York, NY 10027
Tel: 212/854-7248
Fax: 212/854-3239
E-Mail: da2152@columbia.edu

Janet Currie
Princeton University
316 Wallace Hall
Princeton, NJ 08544
Tel: 609-258-7393
Fax: 609-258-5974
E-Mail: jcurrie@princeton.edu

Emilia Simeonova
Department of Economics
Princeton University
355 Wallace Hall
Princeton, NJ 08540
Tel: 617/627-5948
E-Mail: emilia.simeonova@gmail.com
AB  - This paper explores the consequences of the expiration of charity care requirements imposed on private hospitals by the Hill-Burton Act.  We examine delivery care and the health of newborns using the universe of Florida births from 1989-2003 combined with hospital data from the American Hospital Association.  We find that charity care requirements were binding on hospitals, but that private hospitals under obligation “cream skimmed” the least risky maternity patients.  Conditional on patient characteristics, they provided less intensive maternity services but without compromising patient health.  When obligations expired, private hospitals quickly reduced their charity caseloads, shifting maternity patients to public hospitals.  There they received more intensive services, but did not experience improvements in health.  These results suggest that public hospitals provided services less efficiently than private hospitals constrained to provide charity care.
ER  -