Romano, Patrick S.Mutter, Ryan2021-07-222021-07-222004-06Romano, Patrick S.; Mutter, Ryan; The Evolving Science of Quality Measurement for Hospitals: Implications for Studies of Competition and Consolidation; International Journal of Health Care Finance and Economics, volume 4, pages131–157, June 2004; https://doi.org/10.1023/B:IHFE.0000032420.18496.a4https://doi.org/10.1023/B:IHFE.0000032420.18496.a4http://hdl.handle.net/11603/22053The literature on hospital competition and quality is young; most empirical studies have focused on few conditions and outcomes. Measures of in-hospital mortality and complications are susceptible to bias from unmeasured severity and transfer/discharge practices. Only one research team has evaluated related process and outcome measures, and none has exploited chart-review or patient survey-based data. Prior studies have generated inconsistent findings, suggesting the need for additional research. We describe the strengths and limitations of various approaches to quality measurement, summarize how quality has been operationalized in studies of hospital competition, outline three mechanisms by which competition may affect hospital quality, and propose measures appropriate for testing each mechanism.27 pagesen-USThis item is likely protected under Title 17 of the U.S. Copyright Law. Unless on a Creative Commons license, for uses protected by Copyright Law, contact the copyright holder or the author.Public Domain Mark 1.0This work was written as part of one of the author's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.Text