Hospital financial condition and the quality of patient care

Health Econ. 2008 Aug;17(8):977-95. doi: 10.1002/hec.1311.


Concerns about deficiencies in the quality of care delivered in US hospitals grew during a time period when an increasing number of hospitals were experiencing financial problems. Our study examines a six-year longitudinal database of general acute care hospitals in 11 states to assess the relationship between hospital financial condition and quality of care. We evaluate two measures of financial performance: operating margin and a broader profitability measure that encompasses both operating and non-operating sources of income. Our model specification allows for gradual adjustments in quality-enhancing activities and recognizes that current realizations of patient quality may affect future financial performance. Empirical results suggest that there is a relationship between financial performance and quality of care, but not as strong as suggested in earlier research. Overall, our results suggest that deep financial problems that go beyond the patient care side of business may be important to prompting quality problems.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Economics, Hospital
  • Financial Management, Hospital / economics*
  • Humans
  • Quality Assurance, Health Care / economics*
  • Quality Indicators, Health Care
  • United States