COMPETITION AND QUALITY OUTCOMES IN THE HEALTH CARE MARKET: A BILATERAL ANALYSIS

COMPETITION AND QUALITY OUTCOMES IN THE HEALTH CARE MARKET: A BILATERAL ANALYSIS

Author: Tingting Li

Publisher:

Published: 2013

Total Pages: 100

ISBN-13:

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Micro-economic theory suggests both insurance market concentration and hospital market concentration may affect outcomes such as insurance premium and quality of care. Moreover, as concentration in the insurance market and hospital market may interact, it is impossible for economic theory to sign the impact. Using Healthcare Cost and Utilization Project (HCUP) 2007 data this paper addresses the question empirically. Insurance and hospital market concentrations are measured by Herfindahl-Hirschman Index (HHI) and quality of care is measured by length of inpatient stay in days and probability of dying during hospitalization. To address the potential endogeneity problem, lagged values of both markets' HHIs are used as instrumental variables. The results of regressions on length of stay show that, generally, increases of both insurance and hospital market concentration erode the quality of care, while the exact impact of the structure of one market depends on the structure of the other. Study finds a positive correlation between monopoly-monopsony confrontation and quality of care in extreme cases but outcomes experienced by patients in such market are worse than outcomes experienced by patients in competitive markets. Results about inpatient mobility are mixed. These findings suggest that, anti-competition trends in health care market should be closely monitored and regulated.


Competition and Quality in Health Care Markets

Competition and Quality in Health Care Markets

Author: Martin Gaynor

Publisher: Now Publishers Inc

Published: 2006

Total Pages: 83

ISBN-13: 1601980078

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Provides an economic assessment of the impact of competition on quality in health care markets. This book offers performance standards for competition; findings from economic theory; and, empirical evidence on health care competition and quality.


What Do We Know about Competition and Quality in Health Care Markets?

What Do We Know about Competition and Quality in Health Care Markets?

Author: Martin Gaynor

Publisher:

Published: 2006

Total Pages: 60

ISBN-13:

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"The goal of this paper is to identify key issues concerning the nature of competition in health care markets and its impacts on quality and social welfare and to identify pertinent findings from the theoretical and empirical literature on this topic. The theoretical literature in economics on competition and quality, the theoretical literature in health economics on this topic, and the empirical findings on competition and quality in health care markets are surveyed and their findings assessed.Theory is clear that competition increases quality and improves consumer welfare when prices are regulated (for prices above marginal cost), although the impacts on social welfare are ambiguous. When firms set both price and quality, both the positive and normative impacts of competition are ambiguous. The body of empirical work in this area is growing rapidly. At present it consists entirely of work on hospital markets. The bulk of the empirical evidence for Medicare patients shows that quality is higher in more competitive markets. The empirical results for privately insured patients are mixed across studies"--National Bureau of Economic Research web site.


Competition in the Health Care Sector

Competition in the Health Care Sector

Author: Warren Greenberg

Publisher: Beard Books

Published: 2002

Total Pages: 428

ISBN-13: 9781587981302

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Source of the debate on how much competition and regulation are necessary in the health care industry. This is a reprint of proceedings from a 1977 conference.


Death by market power : reform, competition and patient outcomes in the national health service

Death by market power : reform, competition and patient outcomes in the national health service

Author: Martin Gaynor

Publisher:

Published: 2010

Total Pages: 56

ISBN-13:

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The effect of competition on the quality of health care remains a contested issue. Most empirical estimates rely on inference from non experimental data. In contrast, this paper exploits a pro-competitive policy reform to provide estimates of the impact of competition on hospital outcomes. The English government introduced a policy in 2006 to promote competition between hospitals. Patients were given choice of location for hospital care and provided information on the quality and timeliness of care. Prices, previously negotiated between buyer and seller, were set centrally under a DRG type system. Using this policy to implement a difference-in-differences research design we estimate the impact of the introduction of competition on not only clinical outcomes but also productivity and expenditure. Our data set is large, containing information on approximately 68,000 discharges per year per hospital from 162 hospitals. We find that the effect of competition is to save lives without raising costs. Patients discharged from hospitals located in markets where competition was more feasible were less likely to die, had shorter length of stay and were treated at the same cost.


Handbook of Health Economics

Handbook of Health Economics

Author: Mark V. Pauly

Publisher: Elsevier

Published: 2012-01-05

Total Pages: 1149

ISBN-13: 0444535926

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"As a relatively new subdiscipline of economics, health economics has made many contributions to areas of the main discipline, such as insurance economics. This volume provides a survey of the burgeoning literature on the subject of health economics." {source : site de l'éditeur].


Competing on Quality of Care

Competing on Quality of Care

Author: Peter J. Hammer

Publisher:

Published: 2000

Total Pages: 0

ISBN-13:

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As American health care moves from a professionally dominated to a market-dominated model, concerns have been voiced that competition, once unleashed, will focus on price to the detriment of quality. Although quality has been extensively analyzed in health services research, the role of quality in competition policy has not been elucidated. While economists may theorize about non-price competition, courts in antitrust cases often follow simpler models of competition based on price and output, either ignoring quality as a competitive dimension or assuming that it will occur in tandem with price competition. This unsystematic approach is inadequate for the formulation of policy in the health care industry, where quality is a central concern of both consumers and society. Instead, courts need a framework with which to analyze the implications for quality of various market structures and to understand the welfare implications of proposed market changes. A competition policy would seek to evaluate the potential for private markets to protect and improve quality in the health care system. This Article describes the present role of antitrust law in medical markets, explores the issues that would be confronted in developing a competition policy and outlines a research agenda that would begin to accomplish that task.


Essays on Competition in Health Care Markets

Essays on Competition in Health Care Markets

Author: Xing Wu

Publisher:

Published: 2018

Total Pages: 0

ISBN-13:

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Over the last decades, health economics has turned into one of the most active research fields within economics. The structure of health care markets varies enormously across countries, largely influenced by competition among suppliers, the regulation of markets and patient preferences. This dissertation presents an analysis of health care markets especially focusing on price competition and quality competition. Under price competition, a pair of asymmetric pure strategy price equilibria exists in a model with income constraints for the specific case that two physicians locate at the maximum distance from each other and patients pay the same marginal transportation cost. Under quality competition, I investigate the interplay of market transparency and semi-altruism - a specific and interesting aspect unique to markets for health care. Market transparency and semi-altruism show ambiguous effects on welfare. The more altruistic physicians provides weakly higher quality than the less altruistic one. Moreover, I explore individual and social incentives for hospital mergers and their interaction with transparency and find that higher transparency does not always lead to higher quality and higher social welfare. The results indicate that quality is lower after merger. A hospital merger leads to a higher social welfare if the efficiency gains from the merger are sufficiently large. ; eng