RESPONSE TO REGULATORY STRINGENCY: THE CASE OF ANTIPSYCHOTIC MEDICATION USE IN NURSING HOMES

• Published in: Health economics Vol. 21; no. 8; pp. 977 - 993
• Main Authors: Bowblis, John R., Crystal, Stephen, Intrator, Orna, Lucas, Judith A.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.08.2012; Wiley Periodicals Inc
• Subjects: Antipsychotic Agents - administration & dosage; Antipsychotic drugs; antipsychotics; Citations; Complementarity; deficiencies; Diagnosis-Related Groups; Drug use; Drug Utilization; Enforcement; Government Regulation; Health economics; Homes for the Aged - legislation & jurisprudence; Homes for the Aged - statistics & numerical data; Humans; Medical Assistance - statistics & numerical data; Mental Disorders - diagnosis; Mental Disorders - drug therapy; Nursing homes; Nursing Homes - legislation & jurisprudence; Nursing Homes - statistics & numerical data; Nursing Staff - statistics & numerical data; Psychotropic drugs; Quality of care; Quality of Health Care - legislation & jurisprudence; Regulation; Restraint, Physical - utilization; State Government; Studies; United States > US
• ISSN: 1057-9230; 1099-1050
• DOI: 10.1002/hec.1775

SUMMARY This paper studies the impact of regulatory stringency, as measured by the statewide deficiency citation rate over the past year, on the quality of care provided in a national sample of nursing homes from 2000 to 2005. The quality measure used is the proportion of residents who are using antipsychotic medication. Although the changing case‐mix of nursing home residents accounts for some of the increase in the use of antipsychotics, we find that the use of antipsychotics by nursing homes is responsive to state regulatory enforcement in a manner consistent with the multitasking incentive problem. Specifically, the effect of the regulations is dependent on the degree of complementarity between the regulatory deficiency and the use of antipsychotics. Copyright © 2011 John Wiley & Sons, Ltd.