This study provides new findings on the provision of hospital outpatient care to the uninsured using hospital outpatient discharge records from Florida from 1997 through 2008.
We use 1997-2008 outpatient discharge data from private short-term acute care hospitals in Florida.
Thorpe and Phelps 1991), we control for market concentration with a county-level Herfindahl-Hirschman Index (HHI) calculated for each year from the hospital outpatient discharge records, similar to Thorpe and Phelps (1991) and Davidoff et al.
Predicted Medicaid enrollment is calculated by using outpatient discharge records to estimate a linear probability model of whether the patient had Medicaid coverage, where race and ethnicity, sex, age dummies, and four-digit zip code dummies are the explanatory variables.
We identify some of the most common CPT codes on the outpatient discharge records of uninsured patients.
25 Most Common Procedures on Uninsured Patients' Hospital Outpatient Discharge Records, 2008.
We count discharges to uninsured patients when the principal payer is reported as either "charity care," a combined category labeled "self-pay/ underinsured/no third-party coverage or less than 30 percent estimated coverage," or "other state and local government;" we then calculate, for each hospital and year, the number of uninsured outpatient discharges and total charges for these discharges, and the share of all outpatient discharges and the share of all outpatient charges accounted for by uninsured patients.
Finally, to gauge the direct effect of Medicare payment cuts on hospitals' care provision to the Medicare population, we construct several hospital- and year-specific measures of outpatient care provided to Medicare fee-for-service (FFS) patients: the number of Medicare FFS outpatient discharges, the total charges for these discharges, and the shares of all outpatient discharges and all outpatient charges accounted for by Medicare FFS patients.
The top panel shows that the number of outpatient discharges of uninsured patients reached a high of 73,065 in 2004 before falling to 61,793 by 2008.