DP17365 Is Hospital Quality Predictive of Pandemic Deaths? Evidence from US Counties

Author(s): Johannes Kunz, Carol Propper
Publication Date: June 2022
Keyword(s): County-level Deaths, COVID-19, Health Care Systems, Hospital quality
JEL(s): H51, I11, I18
Programme Areas: Public Economics
Link to this Page: cepr.org/active/publications/discussion_papers/dp.php?dpno=17365

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 �xed-e�ects and potential confounders. As a measure of quality, we use the pre-pandemic adjusted �ve-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 �nd 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 �rst recorded death.