Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/286715 
Year of Publication: 
2020
Citation: 
[Journal:] Applied Health Economics and Health Policy [ISSN:] 1179-1896 [Volume:] 18 [Issue:] 5 [Publisher:] Springer International Publishing [Place:] Cham [Year:] 2020 [Pages:] 625-639
Publisher: 
Springer International Publishing, Cham
Abstract: 
Background: Limited empirical evidence exists regarding the effect of price changes on hospital behavior and, ultimately, the quality of care. Additionally, an overview of the results of prior literature is lacking. Objective This study aims to provide a synthesis of existing research concerning the relationship between hospital cost/price and the quality of care. Methods Searches for literature related to the effect of hospital cost and price on the quality of care, including studies published between 1990 and March 2019, were carried out using four electronic databases. In total, 47 studies were identified, and the data were extracted and summarized in different tables to identify the patterns of the relationships between hospital costs/prices and the quality of care. Results The study findings are highly heterogenous. The proportion of studies detecting a significant positive association between price/cost and the quality of care is higher when (a) price/reimbursement is used (instead of cost); (b) process measures are used (instead of outcome measures); (c) the focus is on acute myocardial infarction, congestive heart failure, and stroke patients (instead of patients with other clinical conditions or all patients); and (d) the methodological approach used to address confounding is more sophisticated. Conclusion Our results suggest that there is no general relationship between cost/price and the quality of care. However, the relationship seems to depend on the condition and specific resource utilization. Policy makers should be prudent with the measures used to reduce hospital costs to avoid endangering the quality of care, especially in resource-sensitive settings.
Subjects: 
Pharmacoeconomics and Health Outcomes
Quality of Life Research
Health Economics
Health Administration
Public Health
Persistent Identifier of the first edition: 
Creative Commons License: 
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Document Type: 
Article
Document Version: 
Published Version

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