This paper studies the impact of regulatory stringency in the USA (as measured by the statewide deficiency citation rate over the past year) on the quality of care provided in a US national sample of nursing homes from 2000 to 2005.
The quality measure used in this research is the proportion of residents taking antipsychotic medication. Nursing home residents account for some of the increase in the use of antipsychotics, but the authors assert that use of antipsychotics by nursing homes is responsive to state regulatory enforcement. The effect of the regulations is said to depend on the “degree of complementarity” between the regulatory deficiency and the use of antipsychotics. The wording of the abstract is gloriously arcane, but this is understood here as meaning that more stringent regulation can play a role in the reducing the proportion of residents prescribed antipsychotic medications and enforcing a generally higher quality of care.
Full Text Link (Access to this article requires a suitable password, a journal subscription or a one-off payment)
Bowblis, JR. Crystal, S. [and] Intrator, O. [et al] (2012). Response to regulatory stringency: the case of antipsychotic medication use in nursing homes. Health Economics, August 2012, Vol.21(8), pp.977-93. (Click here to view the PubMed abstract).
Note: A 2010 version of this research is available freely:
Bowblis, JR. Crystal, S. [and] Intrator, O. [et al] (2012). Response to regulatory stringency: the case of antipsychotic medication use in nursing homes. Oxford: Miami University (Farmer School of Business), August 2010. Department of Economics Working Paper. 27p.