TY - JOUR AU - McClellan,Mark AU - Staiger,Douglas TI - The Quality of Health Care Providers JF - National Bureau of Economic Research Working Paper Series VL - No. 7327 PY - 1999 Y2 - August 1999 UR - http://www.nber.org/papers/w7327 L1 - http://www.nber.org/papers/w7327.pdf N1 - Author contact info: Mark B. McClellan Director, Engelberg Center for Health Care Reform Senior Fellow, Economic Studies Leonard .D. Schaeffer Director's Chair in Health Policy ,The Brookings Institution 1775 Massachusetts avenue, N.W. Washington, DC 20036 Tel: (202) 741-6567 Fax: NA E-Mail: mmcclellan@brookings.edu Douglas O. Staiger Dartmouth College Department of Economics HB6106, 301 Rockefeller Hall Hanover, NH 03755-3514 Tel: 603/646-2979 Fax: 603/646-2122 E-Mail: douglas.staiger@dartmouth.edu AB - Obtaining better information on the quality of health care providers is one of the most pressing issues in health policy today. In this paper we (1) develop a new method for measuring quality of care that overcomes the key limitations of available quality measures, and (2) apply this method to estimating the quality of hospital care for elderly patients with heart disease. Our approach optimally combines information from all available current and past quality indicators in order to more accurately estimate and forecast each provider's quality level. For patients with heart disease, the method is able to predict and forecast differences in patient outcomes across hospitals remarkably well - far better than existing methods. Our approach also provides an empirical basis for choosing among potential quality indicators. In particular, we find that differences across hospitals in short-term mortality rates following a heart attack, adjusted for patient demographics, are excellent indicators of quality of care: They vary dramatically across hospitals, are persistent over time, are highly correlated with alternative quality indicators, and are highly correlated with mortality rates that adjust more extensively for patient severity. Thus, comparing quality of care across providers may be far more feasible than many now believe. ER -