Negative effects of mandate measurement: Evidence from Surveys of Patient Experience
Dr. Davide Cianciaruso
Assistant Professor
Accounting and Management Control
HEC Paris
We study whether mandating hospitals to adopt a survey of patient experience affects patient mortality. We exploit two settings where U.S. healthcare regulators mandated the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey: the 2003 Maryland pilot study and the 2007 nationwide adoption. Difference-in-difference analyses show increased mortality for hospitals that were subject to the mandate, relative to other comparable hospitals. The effect occurs pre-HCAHPS public disclosures. Cross-sectional results provide support for the hypothesis that mandated hospitals shifted resources from clinical care to patient experience. In sum, our analyses provide new evidence of negative spillovers of mandated measurements.
