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作者

Johannes S. Kunz;Carol Propper

来源

来源 JOURNAL OF URBAN ECONOMICS,Vol.133,P.

语言

英文

关键字

COVID-19;County-level deaths;Hospital quality;Health care systems;H51;I11;I18

作者单位

Monash University, Monash Business School, 900 Dandenong Road, 3145 Caulfield East, Vic, Australia;Imperial College London, Department of Economics and Public Policy, South Kensington Campus, SW1A 2AZ United Kingdom;Monash University, Monash Business School, 900 Dandenong Road, 3145 Caulfield East, Vic, Australia;Imperial College London, Department of Economics and Public Policy, South Kensington Campus, SW1A 2AZ United Kingdom

摘要

In the large literature on the spatial-level correlates of COVID-19, the association between quality of hospital care and outcomes has received little attention to date. To examine whether county-level mortality is correlated with measures of hospital performance, we assess daily cumulative deaths and pre-crisis measures of hospital quality, accounting for state fixed-effects and potential confounders. As a measure of quality, we use the pre-pandemic adjusted five-year penalty rates for excess 30-day readmissions following pneumonia admissions for the hospitals accessible to county residents based on ambulance travel patterns. Our adjustment corrects for socio-economic status and down-weighs observations based on small samples. We find that a one-standard-deviation increase in the quality of local hospitals is associated with a 2% lower death rate (relative to the mean of 20 deaths per 10,000 people) one and a half years after the first recorded death.