NCPA - National Center for Policy Analysis

Quality of Treatment Varies by Type of Insurance

October 18, 2013

In attempting to explain why hospitals vary in the quality of care delivered to patients, a considerable body of health policy research points to differences in hospital characteristics such as ownership, safety-net status and geographic location as the most important contributing factors, say Christine S. Spencer of the University of Baltimore, and Darrell J. Gaskin and Eric T. Roberts of Johns Hopkins Bloomberg School of Public Health.

Spencer, Gaskin and Roberts examine the extent to which a patient's type or lack of insurance may also play a role in determining the quality of care received at any given hospital.

  • They find that privately insured patients have lower risk-adjusted mortality rates than do Medicare enrollees for 12 out of 15 quality measures examined.
  • To a lesser extent, privately insured patients also have lower risk-adjusted mortality rates than those in other payer groups.
  • Medicare patients appear particularly vulnerable to receiving inferior care.

These findings suggest that to help reduce care disparities, public payers and hospitals should measure care quality for different insurance groups and monitor differences in treatment practices within hospitals.

Source: Christine S. Spencer, Darrell J. Gaskin and Eric T. Roberts, "The Quality of Care Delivered to Patients Within the Same Hospital Varies by Insurance Type," Health Affairs, October 2013.


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