Distinguishing Differences in Quality of Care of Traumatic Brain Injury among Hospitals

There has been an increasing demand for insights into the quality of health care. In this paper we analyse dierences in quality of care among hospitals, using an unbalanced dataset containing observations of patients with traumatic brain in- jury. We discuss random eects and xed eects models which are traditionally used for modeling variation in perfor- mance of hospitals. Results demonstrate that these methods leave a lot of uncertainty about the existence of individual dierences. Findings also reveal that actual dierences are hardly distinguishable. Hence, we propose a nite mixture approach. Our empirical results suggest that three quality groups with hospitals are sucient to describe the variation in health care quality. Classifying hospitals in quality clus- ters provides a correct alternative to current shaky hospital rankings.