Volume 54 | Number 3 | June 2019

Abstract List

Susan Camilleri Ph.D., Jeffrey Diebold PhD


Examine the endogenous relationship between uncompensated care and hospital patient experience scores.

Data Sources/Study Setting

The Hospital Consumer Assessment of Healthcare Providers and Systems Survey, Healthcare Cost Report Information System, and the Census Bureau.

Study Design

The exogenous change in uncompensated care caused by the 2014 Medicaid expansion was exploited to measure the effect of uncompensated care on patient experience scores using a 2 regression with instrumental variables approach.

Data Collection/Extraction Methods

U.S. general, short‐term hospitals whose status remained constant and had nonmissing data for 2011‐2015, which totaled 969 unique hospitals per year.

Principal Findings

The effect of uncompensated care on patient experience was in the predicted direction, with three of the 10 measures being statistically significant. A one percentage point increase in uncompensated care costs resulted in a 0.25‐0.50 percentage point decrease in select patient experience scores.


Results indicate a weak relationship between uncompensated care and patient experience scores, as a reduction in uncompensated care is related to quality improvement for some hospitals. These findings have implications for hospitals as they navigate changing reimbursement structures and policy makers considering changes to Obama‐era health care reforms.