Frontiers in Health Policy Research.

• Position: Conference of the National Bureau of Economic Research

The NBER's second annual conference on "Frontiers in Health Policy Research" was held on June 11 in Bethesda, Maryland. Health Care Program Director Alan M. Garber, of NBER and Stanford University, chose the following papers for presentation:

Frank A. Sloan, NBER and Duke University; Gabriel Picone, University of South Florida; and Donald Taylor and Shin-Yi Chou, Duke University; "Does Where You Are Admitted Make a Difference? An Analysis of Medicare Data"

Laurence C. Baker, NBER and Stanford University, and Joanne Spetz, Public Policy Institute of California, "Managed Care and Medical Technology Growth"

Daniel Kessler and Mark B. McClellan, NBER and Stanford University, "Does Hospital Competition Raise the Price of Hospital Services?"

Alan M. Garber, Thomas E. MaCurdy, and Mark B. McClellan, NBER and Stanford University, "Medical Care at the End of Life: Diseases, Treatment Patterns, and Costs"

David M. Cutler, NBER and Harvard University, and Elizabeth Richardson, Harvard University, "Your Money and Your Life: The Value of Health and What Affects It"

How does hospital ownership affect performance in terms of cost and quality? Sloan, Picone, Taylor, and Chou ask whether following a sudden, unanticipated adverse health event, it matters to which type of hospital a Medicare beneficiary is taken. In their study, cost is measured by actual Medicare payments, both for hospital and for nonhospital care. They use Medicare data from a nationwide sample of nearly 2,700 elderly patients in almost 1,400 hospitals. The authors also assess variations in direct measures of intensity of hospital care by ownership and other factors. In this paper, the focus is on long-term survival following initial hospital admission for a "health shock." In total, they find, government hospitals were the least expensive for Medicare, with major teaching hospitals being most expensive within six months of admission after the "index event." However, survival was best in major teaching hospitals. In terms of payments subsequent to those for the initial hospitalization, Medicare spent more for patients admitted to for-profit hospitals than for those admitted to other non-teaching facilities, but had similar outcomes as measured by survival. Payments on behalf of patients treated in for-profit hospitals were higher for Medicare Part B and home health, especially during the first two months following discharge from the initial hospital stay.

Baker and Spetz attempt to better...