This study uses data on hospital closures to examine the relation between exit and inefficiency i... more This study uses data on hospital closures to examine the relation between exit and inefficiency in an industry where for-profit, not-for-profit, and government firms coexist. The likelihood of hospital exit over the period 1986-91 is estimated as a function of hospital relative inefficiency, ownership type, and other factors, where hospital relative inefficiency is measured using residuals from estimation of a stochastic frontier cost function. We find that less efficient hospitals were more likely to exit when ownership was for-profit or not-for-profit, but that relative inefficiency did not have a significant effect on the probability of exit for government hospitals.
inpatient data are from the Pennsylvania Health Care Cost Containment Council (PHC4). PHC4 is an ... more inpatient data are from the Pennsylvania Health Care Cost Containment Council (PHC4). PHC4 is an independent state agency responsible for addressing the problem of escalating health costs, ensuring the quality of healthcare, and increasing access to healthcare for all citizens regardless of ability to pay. PHC4 has provided data to this entity in an effort to further PHC4's mission of educating the public and containing health care costs in Pennsylvania. PHC4, its agents, and staff, have made no representation, guarantee, or warranty, express or implied, that the data ‐‐ financial, patient, payor, and physician specific information ‐‐ provided to this entity, are error‐ free, or that the use of the data will avoid differences of opinion or interpretation. This analysis was not prepared by PHC4. PHC4, its agents and staff, bear no responsibility or liability for the results of the analysis, which are solely the opinion of the authors. 2
BACKGROUND Patients may use two information sources about a health care provider’s quality: onlin... more BACKGROUND Patients may use two information sources about a health care provider’s quality: online physician reviews, which are written by patients to reflect their subjective experience, and report cards, which are based on objective health outcomes. OBJECTIVE The aim of this study was to examine the impact of online ratings on patient choice of cardiac surgeon compared to that of report cards. METHODS We obtained ratings from a leading physician review platform, Vitals; report card scores from Pennsylvania Cardiac Surgery Reports; and information about patients’ choices of surgeons from inpatient records on coronary artery bypass graft (CABG) surgeries done in Pennsylvania from 2008 to 2017. We scraped all reviews posted on Vitals for surgeons who performed CABG surgeries in Pennsylvania during our study period. We linked the average overall rating and the most recent report card score at the time of a patient’s surgery to the patient’s record based on the surgeon’s name, focusing...
Background Patients may use two information sources about a health care provider’s quality: onlin... more Background Patients may use two information sources about a health care provider’s quality: online physician reviews, which are written by patients to reflect their subjective experience, and report cards, which are based on objective health outcomes. Objective The aim of this study was to examine the impact of online ratings on patient choice of cardiac surgeon compared to that of report cards. Methods We obtained ratings from a leading physician review platform, Vitals; report card scores from Pennsylvania Cardiac Surgery Reports; and information about patients’ choices of surgeons from inpatient records on coronary artery bypass graft (CABG) surgeries done in Pennsylvania from 2008 to 2017. We scraped all reviews posted on Vitals for surgeons who performed CABG surgeries in Pennsylvania during our study period. We linked the average overall rating and the most recent report card score at the time of a patient’s surgery to the patient’s record based on the surgeon’s name, focusing...
In July 2002, a global budgeting system was imposed on hospitals in Taiwan. This system set a fix... more In July 2002, a global budgeting system was imposed on hospitals in Taiwan. This system set a fixed budget for all hospitals within a region but included special provisions that sheltered reimbursements for drug expenditures. We study the size and nature of changes in hospital physicians' use of drugs for outpatient care following this budgetary change and find that drug expenditures for outpatient care increased by 11.7%. Our results suggest that physicians began prescribing more expensive drugs, more drugs, and drugs for longer periods but that these different responses did not all occur at the same time. The overall response was strongest in for‐profit hospitals, but drug‐related decisions changed in all hospital types.
An examination of the usefulness of two measures of capacity utilization in predicting price pres... more An examination of the usefulness of two measures of capacity utilization in predicting price pressures and future investment: one measure attempts to represent the maximum physical output a plant can produce, and one is based on changes in production costs as output increases; article concludes with July 1 issue.
... both by economic factors (relative inefficiency) and community need (population growth and ex... more ... both by economic factors (relative inefficiency) and community need (population growth and extent of service offerings) when ... between actual and best-practice costs, while the OLS measure includes all factors influencing unexplained costs ... 746 The Journal of Human Resources ...
Journal of the American Medical Informatics Association : JAMIA, Jan 18, 2016
To determine the effect of availability of clinical information from an integrated electronic hea... more To determine the effect of availability of clinical information from an integrated electronic health record system on pregnancy outcomes at the point of care. We used provider interviews and surveys to evaluate the availability of pregnancy-related clinical information in ambulatory practices and the hospital, and applied multiple regression to determine whether greater clinical information availability is associated with improvements in pregnancy outcomes and changes in care processes. Our regression models are risk adjusted and include physician fixed effects to control for unobservable characteristics of physicians that are constant across patients and time. Making nonstress test results, blood pressure data, antenatal problem lists, and tubal sterilization requests from office records available to hospital-based providers is significantly associated with reductions in the likelihood of obstetric trauma and other adverse pregnancy outcomes. Better access to prenatal records also ...
We study consumers’ valuation of status signals by estimating consumers’ willingness to pay for a... more We study consumers’ valuation of status signals by estimating consumers’ willingness to pay for a luxury item with a quiet vs. a prominent logo. We collected data from two online markets on sales of two luxury handbags that differ only in the prominence of their logo. We use these data to estimate the premium in consumers’ willingness to pay for the handbag with the quiet logo, as well as to test hypotheses as to how the condition of the handbag and the sales mode affects that premium. We find consumers are willing to pay a sizeable premium of $151-$189, or 15-20% of the retail price, for the quiet handbags as compared to the loud handbags. This price premium decreases as a handbag’s condition worsens, but is larger for quiet handbags purchased at a fixed price rather than at auction. Our findings provide empirical support for research suggesting that an elite set of consumers, i.e., consumers with more social capital or social connectedness, are willing to pay a premium for quiet luxury goods.
Journal of the American Medical Informatics Association : JAMIA, 2018
The installation of EHR systems can disrupt operations at clinical practice sites, but also lead ... more The installation of EHR systems can disrupt operations at clinical practice sites, but also lead to improvements in information availability. We examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. We collected data on provider satisfaction through 4 survey rounds during the phased implementation of the EHR. Data on patient satisfaction were drawn from Press Ganey surveys issued by the healthcare network through a standard process. Using multivariable models, we determined how provider satisfaction with information transmission and patient satisfaction with their care experience changed as the EHR system allowed greater information flow between OB/GYN practices and the hospital. Outpatient OB/GYN providers became more satisfied with their access to information from the inp...
We estimate a gender differential in the intergenerational transmission of adverse birth outcomes... more We estimate a gender differential in the intergenerational transmission of adverse birth outcomes. We link Taiwan birth certificates from 1978 to 2006 to create a sample of children born in the period 1999-2006 that includes information about their parents and their maternal grandmothers. We use maternal-sibling fixed effects to control for unobserved family-linked factors that may be correlated with birth outcomes across generations, and define adverse birth outcomes as small for gestational age. We find that when a mother is in the 5th percentile of birth weight for her gestational age, then her female children are 49-53% more likely to experience the same adverse birth outcome compared to other female children, while her male children are 27-32% more likely to experience this relative to other male children. We then investigate whether long-run improvements in local socio-economic conditions experienced by the child's family, as measured by intergenerational changes in town-l...
This study uses data on hospital closures to examine the relation between exit and inefficiency i... more This study uses data on hospital closures to examine the relation between exit and inefficiency in an industry where for-profit, not-for-profit, and government firms coexist. The likelihood of hospital exit over the period 1986-91 is estimated as a function of hospital relative inefficiency, ownership type, and other factors, where hospital relative inefficiency is measured using residuals from estimation of a stochastic frontier cost function. We find that less efficient hospitals were more likely to exit when ownership was for-profit or not-for-profit, but that relative inefficiency did not have a significant effect on the probability of exit for government hospitals.
inpatient data are from the Pennsylvania Health Care Cost Containment Council (PHC4). PHC4 is an ... more inpatient data are from the Pennsylvania Health Care Cost Containment Council (PHC4). PHC4 is an independent state agency responsible for addressing the problem of escalating health costs, ensuring the quality of healthcare, and increasing access to healthcare for all citizens regardless of ability to pay. PHC4 has provided data to this entity in an effort to further PHC4's mission of educating the public and containing health care costs in Pennsylvania. PHC4, its agents, and staff, have made no representation, guarantee, or warranty, express or implied, that the data ‐‐ financial, patient, payor, and physician specific information ‐‐ provided to this entity, are error‐ free, or that the use of the data will avoid differences of opinion or interpretation. This analysis was not prepared by PHC4. PHC4, its agents and staff, bear no responsibility or liability for the results of the analysis, which are solely the opinion of the authors. 2
BACKGROUND Patients may use two information sources about a health care provider’s quality: onlin... more BACKGROUND Patients may use two information sources about a health care provider’s quality: online physician reviews, which are written by patients to reflect their subjective experience, and report cards, which are based on objective health outcomes. OBJECTIVE The aim of this study was to examine the impact of online ratings on patient choice of cardiac surgeon compared to that of report cards. METHODS We obtained ratings from a leading physician review platform, Vitals; report card scores from Pennsylvania Cardiac Surgery Reports; and information about patients’ choices of surgeons from inpatient records on coronary artery bypass graft (CABG) surgeries done in Pennsylvania from 2008 to 2017. We scraped all reviews posted on Vitals for surgeons who performed CABG surgeries in Pennsylvania during our study period. We linked the average overall rating and the most recent report card score at the time of a patient’s surgery to the patient’s record based on the surgeon’s name, focusing...
Background Patients may use two information sources about a health care provider’s quality: onlin... more Background Patients may use two information sources about a health care provider’s quality: online physician reviews, which are written by patients to reflect their subjective experience, and report cards, which are based on objective health outcomes. Objective The aim of this study was to examine the impact of online ratings on patient choice of cardiac surgeon compared to that of report cards. Methods We obtained ratings from a leading physician review platform, Vitals; report card scores from Pennsylvania Cardiac Surgery Reports; and information about patients’ choices of surgeons from inpatient records on coronary artery bypass graft (CABG) surgeries done in Pennsylvania from 2008 to 2017. We scraped all reviews posted on Vitals for surgeons who performed CABG surgeries in Pennsylvania during our study period. We linked the average overall rating and the most recent report card score at the time of a patient’s surgery to the patient’s record based on the surgeon’s name, focusing...
In July 2002, a global budgeting system was imposed on hospitals in Taiwan. This system set a fix... more In July 2002, a global budgeting system was imposed on hospitals in Taiwan. This system set a fixed budget for all hospitals within a region but included special provisions that sheltered reimbursements for drug expenditures. We study the size and nature of changes in hospital physicians' use of drugs for outpatient care following this budgetary change and find that drug expenditures for outpatient care increased by 11.7%. Our results suggest that physicians began prescribing more expensive drugs, more drugs, and drugs for longer periods but that these different responses did not all occur at the same time. The overall response was strongest in for‐profit hospitals, but drug‐related decisions changed in all hospital types.
An examination of the usefulness of two measures of capacity utilization in predicting price pres... more An examination of the usefulness of two measures of capacity utilization in predicting price pressures and future investment: one measure attempts to represent the maximum physical output a plant can produce, and one is based on changes in production costs as output increases; article concludes with July 1 issue.
... both by economic factors (relative inefficiency) and community need (population growth and ex... more ... both by economic factors (relative inefficiency) and community need (population growth and extent of service offerings) when ... between actual and best-practice costs, while the OLS measure includes all factors influencing unexplained costs ... 746 The Journal of Human Resources ...
Journal of the American Medical Informatics Association : JAMIA, Jan 18, 2016
To determine the effect of availability of clinical information from an integrated electronic hea... more To determine the effect of availability of clinical information from an integrated electronic health record system on pregnancy outcomes at the point of care. We used provider interviews and surveys to evaluate the availability of pregnancy-related clinical information in ambulatory practices and the hospital, and applied multiple regression to determine whether greater clinical information availability is associated with improvements in pregnancy outcomes and changes in care processes. Our regression models are risk adjusted and include physician fixed effects to control for unobservable characteristics of physicians that are constant across patients and time. Making nonstress test results, blood pressure data, antenatal problem lists, and tubal sterilization requests from office records available to hospital-based providers is significantly associated with reductions in the likelihood of obstetric trauma and other adverse pregnancy outcomes. Better access to prenatal records also ...
We study consumers’ valuation of status signals by estimating consumers’ willingness to pay for a... more We study consumers’ valuation of status signals by estimating consumers’ willingness to pay for a luxury item with a quiet vs. a prominent logo. We collected data from two online markets on sales of two luxury handbags that differ only in the prominence of their logo. We use these data to estimate the premium in consumers’ willingness to pay for the handbag with the quiet logo, as well as to test hypotheses as to how the condition of the handbag and the sales mode affects that premium. We find consumers are willing to pay a sizeable premium of $151-$189, or 15-20% of the retail price, for the quiet handbags as compared to the loud handbags. This price premium decreases as a handbag’s condition worsens, but is larger for quiet handbags purchased at a fixed price rather than at auction. Our findings provide empirical support for research suggesting that an elite set of consumers, i.e., consumers with more social capital or social connectedness, are willing to pay a premium for quiet luxury goods.
Journal of the American Medical Informatics Association : JAMIA, 2018
The installation of EHR systems can disrupt operations at clinical practice sites, but also lead ... more The installation of EHR systems can disrupt operations at clinical practice sites, but also lead to improvements in information availability. We examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers' satisfaction with the transmission of clinical information and patients' ratings of their care experience. We collected data on provider satisfaction through 4 survey rounds during the phased implementation of the EHR. Data on patient satisfaction were drawn from Press Ganey surveys issued by the healthcare network through a standard process. Using multivariable models, we determined how provider satisfaction with information transmission and patient satisfaction with their care experience changed as the EHR system allowed greater information flow between OB/GYN practices and the hospital. Outpatient OB/GYN providers became more satisfied with their access to information from the inp...
We estimate a gender differential in the intergenerational transmission of adverse birth outcomes... more We estimate a gender differential in the intergenerational transmission of adverse birth outcomes. We link Taiwan birth certificates from 1978 to 2006 to create a sample of children born in the period 1999-2006 that includes information about their parents and their maternal grandmothers. We use maternal-sibling fixed effects to control for unobserved family-linked factors that may be correlated with birth outcomes across generations, and define adverse birth outcomes as small for gestational age. We find that when a mother is in the 5th percentile of birth weight for her gestational age, then her female children are 49-53% more likely to experience the same adverse birth outcome compared to other female children, while her male children are 27-32% more likely to experience this relative to other male children. We then investigate whether long-run improvements in local socio-economic conditions experienced by the child's family, as measured by intergenerational changes in town-l...
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Papers by Mary Deily