The effect of soft budget constraints on access and quality in hospital care
MetadataShow full item record
Given an increasingly complex web of financial pressures on providers, studies have examined how the hospitals' overall financial health affect different aspects of hospital operation. In our study, we analyze this issue focusing on hospital access and quality by introducing an important aspect of the financial incentives, soft budget constraints (SBC), that take into account both hospital's current and past financial health as well as their expected financial outlook (i.e., whether there is a sponsoring organization to bail them out). We develop a conceptual framework of SBC by considering the resultant incentives on cost control and quality improvement innovations; and examine the effect of SBC on the following aspects of access and quality: safety net service survival and AMI mortality rates. We find that hospitals with softer budget constraints appear to have better mortality outcomes, suggesting that the reduced incentive to engage in cost control innovation as the result of SBC outweighs the dampening effect of quality improvement innovation.
RightsThis publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.
Showing items related by title, author, creator and subject.
Tan Soon; Meng Alvin (Monterey, California. Naval Postgraduate School, 2007-06);Pressure on emergency medical services (EMS) is rising. The growth in EMS utilization has coincided with a decline in the number of emergency departments (ED). Between 1994 and 2004, the annual number of ED visits in the ...
Kadowaki, Jay Akira.; Rowley, James L. (Monterey, California. Naval Postgraduate School, 2001-03);The Patuxent River Naval Hospital is examining methods to provide the highest quality and access to care at the lowest cost possible. To do this, a number of data or information needs must be identified. It is the purpose ...
Shen, Yu-Chu; Zuckerman, Stephen (Health Research and Education Trust, 2005);Objective: This study examines the effects of Medicaid payment generosity on access and care for adult and child Medicaid beneficiaries. Data Source: Three years of the National Surveys of America's Families (1997, 1999, ...