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Question 1 (25 credits):

The attached dataset, provides some information about hospitals in 2011 and 2012, download the data and then complete the descriptive table. Please use the following questions.

  • In term of hospital characters what are the significant difference between 2011 and 2012?
  • In term of socio-economic variables what are the significant difference between 2011 and 2012?
  • Based on your findings in which years hospitals had better performance? How hospital performance related to hospital characteristics and socio-economic characteristics? Please write at least three main different movements between 2011 and 2012.

To report the “Per Capita Hospital Beds to Population”, you need to divide “total_hospital_beds/ tot_population)

Table 1. Descriptive statistics between hospitals in 2011 & 2012

2011

2012

p-value

N

Mean

St. Dev

N

Mean

St. Dev

Hospital Characteristics

1. Hospital beds

2. Number of paid Employee

3. Number of non-paid Employee

4. Internes and Residents

5. System Membership

6. Total hospital cost

7. Total hospital revenues

8. Hospital net benefit

9. Available Medicare days

10. Available Medicaid days

11. Total Hospital Discharge

12. Medicare discharge

13. Medicaid discharge

Soci-Economic Variables

14. Per Capita Hospital Beds to Population

15. Percent of population under poverty

16. Percent of Female population under poverty

17.Percent of Male population under poverty

18. Median Household Income

(Note: You can use week 1 exercise’s codes to answer this question, but you need to modify that for this analysis)

Question 2 (25 credits):

Use the dataset from week1 exercise and then answer the following questions:

  • Compare the following information between for-profit and non-for-profit hospitals.
  • What are the main significant differences between for-profit and non-for-profit hospitals? Which test is the best fit test? Why?
  • Use a box-plot and compare Hospital net benefit between for-profit and non-for-profit hospitals.
  • Show another scatter plot and compare hospital cost (x-axes) and revenue (y-axes) and discuss your findings?
  • Comparing hospital net-benefit which hospitals has better performance? To answer this question first compute the hospital net benefits with subtracting hospital costs and revenues and then use ttest to compare the significant differences between teaching and non-teaching hospitals.
  • Overall, what are the main significant differences between for-profit and non-for-profit hospitals?

Table 2. Descriptive statistics between teaching and non-teaching hospitals, 2011 & 2012

For Profit

Non-For-Profit

p-value

N

Mean

St. Dev

N

Mean

St. Dev

Hospital Characteristics

1. Hospital beds

2. Number of paid Employee

3. Number of non-paid Employee

4. Internes and Residents

5. System Membership

6. Total hospital cost

7. Total hospital revenues

8. Hospital net benefit

9. Available Medicare days

10. Available Medicaid days

11. Total Hospital Discharge

12. Medicare discharge

13. Medicaid discharge

Soci-Economic Variables

14. Per Capita Hospital Beds to Population

15. Percent of population under poverty

16. Percent of Female population under poverty

17.Percent of Male population under poverty

18. Median Household Income

(Note: You can use week 2 exercise’s codes for this analysis, you need to modify that for this analysis).

Question 3 (25 credits):

The dataset provides Herfindahl–Hirschman Index for health insurance market, please use the herf_ins variable and answer the following questions:

For this exercise you do not need to compute the HHI, but if you have any questions, please do not hesitate to ask me, but try to learn more about this you will need that to report your findings.

Please remember for the class exercise you used the herf_cat as a hospital herfindahl index for this question make sure to use herf_ins as herfindahl index for insurance market.

Use the dataset from week1 exercise and then answer the following questions:

  • In a short paragraph explain the herfindahl index you can use the reference provided in the class exercise or any other citation.
  • Compare the following information between hospitals located in high, moderate and low competitive health insurance markets?
    • What are the main significant differences between hospitals in different markets? (use Anova test)
    • What is the impact of being in high-competitive health insurance market on hospital revenues and cost?
    • Do you think being in high-competitive market has positive impact on net hospital benefits?
    • What about the number of Medicare and Medicaid discharge? Do you think hospitals in higher completive market more likely to accept more Medicare and Medicaid patients?
    • What are the impact of other variables?
  • Run a regression model use the benefit as a dependent variable and hospital beds, herf_index, Medicare and Medicaid discharges, system membership, and number of interns and residents as independent variables and discuss your findings.

(Note: to answer to the last question, please compute the ratio-Medicare-discharge and ratio-Medicaid-discharge first and then run 2 ttest) high vs. moderate and high vs. low competitive market), please support your findings with box-plot).

Table 3. Comparing hospital characteristics and market, 2011 and 2012

High Competitive Market

Moderate Competitive Market

Low Competitive

Market

ANOVA/Chi-Sq (results)

Hospital Characteristics

N

Mean

STD

N

Mean

STD

N

Mean

STD

1. Hospital beds

2. Number of paid Employee

3. Number of non-paid Employee

4. Internes and Residents

5. System Membership

6. Total hospital cost

7. Total hospital revenues

8. Hospital net benefit

9. Available Medicare days

10. Available Medicaid days

11. Total Hospital Discharge

12. Medicare discharge-ratio

13. Medicaid discharge-ratio

Soci-Economic Variables

14. Per Capita Hospital Beds to Population

15. Median Household Income

(Note: You can use week 3 exercise’s codes for this analysis, you need to modify that for this analysis).

Question 4 (25 credits):

You need to explore the impact of hospital characteristics on hospital wage, so please follow these steps to make your dataset ready for the analysis. You need to compute the Medicare-discharge-ratio and Medicaid-discharge-ratio, if you answered to questions 3 you already generated these variables.

When you have your data ready, please answer the following questions:

Table 4. Comparing hospital characteristics and market, 2011 and 2012

2011 & 2012

Hospital Characteristics

N

Mean

St. Dev

Hospital beds

System Membership

Teaching Status

Non-for-profit

Total hospital cost

Socio-Economic Characteristics

Medicare discharge ratio

Medicaid discharge ratio

Being in the Rural areas

Per Capita Hospital Beds to Population

Median Household Income

(Note: Master RStudio script is available for this exercise, but you need to modify that for this analysis)

Question 5. Regression

1st Model:

Run a linear model and predict the difference between hospital beds (use the bed-tot) and non-for-profit on hospital’s wage? Discuss your finding, do you think having higher beds has positive impact on the hospital wage? What about the non-for-profit?
 

2nd Model:

Now, estimate the impact of being a member of a system and teaching hospitals and hospital cost on hospital’s wage? And discuss your finding (nor more than 2 lines)? Is it significant?

3nd Model:

Now, include the ratio of ratio-Medicare-discharge and ratio-Medicaid-discharge in your model? How do you evaluate the impact of having higher Medicare and Medicaid patients on hospital revenues?

4th Model:

For the last model add hospital bed-percapita, being in a rural areas and household income and discuss your findings?

Based on your finding please recommend 3 policies to improve hospital performance, please make sure to use the final model for your recommendation.

Please also add at least two policy recommendations for the community for example how do you treat household with lower income? And people who are in areas with lower hospital beds?

As the final suggestion what is the impact of being in rural areas on hospital wage?

Model 1

Model 2

Model 3

Model 4

Hospital Characteristics

Coeff.

St. Err

Coeff.

St. Err

Coeff.

St. Err

Coeff.

St. Err

Hospital beds

Non-for-profit

System Membership

Teaching Status

Total hospital cost

Socio-Economic Characteristics

Medicare discharge ratio

Medicaid discharge ratio

Being in the Rural areas

Per Capita Hospital Beds to Population

Median Household Income

N

R-Squared

(Note: You can use week 5 exercise’s codes for this analysis, you need to modify that for this analysis).

Please use this file to answer the questions and submit to the exercise submission folder.

Notes:

you can use excel

Useful formula and guideline.

The computation of the p-value is illustrated in following figures.