Kathleen Carey, Ph.D.

October 1, 2008

Kathleen Carey, Ph.D., is an associate professor of health policy and management at Boston University School of Public Health. Her research primarily focuses on hospitals and the impact of organizational structure on provider performance, with emphasis on the factors influencing hospital and health care costs. As a part of this research, Dr. Carey has developed and modified econometric models and methodologies for examining hospital cost functions.

Dr. Carey holds a Ph.D. in economics from Boston University, a M.A.T. in education from Harvard University, and a B.A. in mathematics from LeMoyne College. In addition to teaching at Boston University School of Public Health, Dr. Carey has served on the faculty at Wellesley College, Harvard University, and the University of Massachusetts, Harbor Campus.

Dr. Carey served as the principal investigator for a HCFO-sponsored study-funded under a special topic solicitation on specialty hospitals-that examined the cost efficiency of physician-owned, single specialty hospitals (SSHs). Specialty hospitals are lauded by some as a mechanism for increasing competition within health care markets, thereby decreasing costs. Others, however, believe that specialty hospitals provoke unfair competition. To inform this debate, Dr. Carey and colleagues compared the cost efficiency of physician-owned specialty hospitals (cardiac, orthopedic, and surgical SSHs) to competing full-service hospitals between 1998 and 2004. The researchers identified SSHs in three states- Arizona, California, and Texas -with a large number of SSHs and competing full-service hospitals within each SSH's hospital referral region (HRR). Using data from Medicare Cost Reports, the American Hospital Association Annual Survey Database, and state administrative data, the researchers used stochastic frontier regression analysis (SFA) to estimate the hospital cost function and analyze the cost inefficiency of care at SSHs and full-service hospitals.

Dr. Carey and her colleagues concluded that overall, SSHs are not more cost-efficient than full-service hospitals. While there was no significant difference between cardiac SSH and full-service hospital cost inefficiency, there was a significant difference between orthopedic/surgical SSHs and full-service hospitals.  Dr. Carey points out that, "for orthopedic and surgical specialty hospitals, our results did not support the argument that specialization in the hospital improves cost efficiency." Dr. Carey further suggests that "policymakers should distinguish between different types of SSHs when making related policy decisions." Additional findings from this grant may be viewed at /pdf/findings1008.pdf.

For more information about Kathleen Carey, Ph.D., and a list of her publications, please see http://sph.bu.edu/index.php?option=com_sphdir&id=239&Itemid=340&INDEX=6093.