Government Regulation and the Quality of Health Care: Evidence from Minimum Staffing Legislation for Nursing Homes
Posted: 3 Feb 2013
Date Written: February 1, 2013
Abstract
This paper investigate the causal eect of a regulation for California nursing homes that required a minimum number of nurse hours per patient day on the quality of health care measured both by patient outcomes and deciency citations from facility inspections. The research design employed is based on the insight that compliance with the law induces a kinked relationship between average nurse employment increases and initial stang levels in the period following adoption: firms should increase employment of nurses in proportion to the gap between their initial staffing level and the legislated minimum threshold. If higher nurse stang causes better quality, then the changes in quality outcomes should mirror these changes. Despite inducing increases in nurse aide hours worked of up to 30 percent for some firms, and about 10 percent across all firms initially out of compliance, I find no impact of the staffing regulation on patient outcomes or overall facility quality.
Keywords: Minimum staffing regulation, health outcomes, nursing home
JEL Classification: I10, I18, J08
Suggested Citation: Suggested Citation