Market Structure and Hospital Efficiency: Evaluating Potential Effects of Deregulation in a National Health Service
Review of Industrial OrganizationPublished 1 August 1998
Eulália Dalmau-Atarrodona, Jaume Puig‐Junoy
Citations52
SJR quartileQ1
SJR score1.07
SNIP0.89
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The results suggest that the number of competitors in the market contributes positively to technical efficiency and there is some evidence that the differences in efficiency scores are attributed to several environmental factors such as ownership, market structure and regulation effects.
Abstract
Geographic markets, market concentration, technical efficiency, data envelopment analysis, censored regression model,
Keywords
Decision SciencesEconomics, Econometrics and Finance
Management ScienceSome Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis
16,569 Citations1984Rajiv D. Banker, A. Charnes +1 more
The Journal of FinanceIndustrial Market Structure and Economic Performance.
6,393 Citations1971H. Michael Mann, F. M. Scherer
Industrial Market Structure and Economic Performance
2,628 Citations1990F. M. Scherer, David Gaddis Ross
European Journal of Operational ResearchEstimation of returns to scale using data envelopment analysis
730 Citations1992Rajiv D. Banker, Robert Thrall
Journal of Health EconomicsThe impact of hospital market structure on patient volume, average length of stay, and the cost of care
409 Citations1985James C. Robinson, Harold S. Luft
Under the retrospective reimbursement system in place at the time, hospitals in more competitive environments exhibited significantly higher costs of production than did those in less competitive environments.
Journal of Health EconomicsMeasuring hospital efficiency with frontier cost functions
358 Citations1994Stephen Zuckerman, Jack Hadley +1 more
A stochastic frontier multiproduct cost function is used to derive hospital-specific measures of inefficiency and it is concluded that inefficiency accounts for 13.6 percent of total hospital costs.
The RAND Journal of EconomicsIs Hospital Competition Wasteful?
209 Citations1992David Dranove, Mark Shanley +1 more
A model predicting the provision of specialized services in local markets and analysis of California hospitals provides minimal support for the medical arms race hypothesis while suggesting substantial scale economies for many services.
PubMedAppropriate measures of hospital market areas.
206 Citations1987Deborah W. Garnick, Harold S. Luft +2 more
Market areas are compared based on various descriptions using data on California hospitals and patient discharge abstracts to provide a framework for evaluating which definitions of hospital market areas are suitable for various types of analyses.
The Economic JournalDeveloping the Health Care Market
185 Citations1991Alan Maynard
There has been an attempt to enhance market contestability in health care provision by formalising relationships between buyers and sellers and investigating and evaluating the reforms which have occurred.
Journal of Health EconomicsCompetition among hospitals
166 Citations1988Monica Noether
The results suggest that both price and quality competition are greater in markets that are less concentrated, although the net effect of the two on prices is insignificant.
Journal of Health EconomicsNursing home care in The Netherlands: a nonparametric efficiency analysis
164 Citations1994Peter Kooreman
This paper analyzes the technical efficiency of Dutch nursing homes with respect to the use of labor inputs by means of Data Envelopment Analysis (DEA) and the determinants of the efficiency scores are investigated using censored regression analysis.
Health PolicyCost containment and health care reform: a study of the European Union
122 Citations1994Brian Abel‐Smith, Elías Mossialos
The article shows the considerable convergence of policies which is developing and gives a summary of the cost containment measures in the 12 countries, listing them under a set of headings.
JAMAHospital Behavior Under Competition and Cost-Containment Policies
115 Citations1988Glenn Melnick
It is concluded that California's pro-competition policies are having dramatic and potentially far-reaching effects on the nature of hospital competition, leading to increased competition based on price.
Law and Contemporary ProblemsDefining Geographic Markets for Hospital Care
90 Citations1988Michael A. Morrisey, Frank A. Sloan +1 more
Until recently, efforts to examine hospital competition and efforts to allow for competing firms in analyses of hospital behavior have used geopolitical boundaries to describe hospital markets, which are handy, but probably economically meaningless.
Medical CareOwnership and Technical Efficiency of Hospitals
89 Citations1990Vivian Valdmanis
The findings in this paper revealed the sample public hospitals to be more efficient relative to the sample NFP hospitals, illustrating the applicability of the nonparametric technique in the measurement of relative technical productive performance between NFP and public hospitals.
Medical CareFinancial Pressure and Competition
68 Citations1996Jack Hadley, Stephen Zuckerman +1 more
It is concluded that health care reforms or market forces that put financial pressures on hospitals can result in cost-containment and improved efficiency without significant cost-shifting.
Journal of Public EconomicsMarket structure and prices: The responses of hospitals in the UK National Health Service to competition
68 Citations1996Carol Propper
The pricing responses of NHS suppliers to competition are examined and hypotheses that prices should differ between buyers and markets are tested using data on spot market transactions between hospitals and health care buyers.
Journal of Health EconomicsThe limited relevance of patient migration data in market delineation for hospital merger cases
57 Citations1990Gregory J. Werden
A model is presented in which hospitals and patients exist at two points and in which a significant number of patients migrate from one point to the other because of perceived quality differences, and it is shown that a monopolist at the higher quality point generally would raise price significantly.
Southern Economic JournalProfit Incentives and Technical Efficiency in the Production of Hospital Care
56 Citations1987Charles A. Register, Edward R. Bruning
The purpose of this paper is to evaluate the relationship between hospital ownership and technical efficiency in the production of hospital care and the literature review is presented to show the types of hypotheses previously considered and the inconclusive nature of previous work in the area of profit incentives and the produced hospital care.
Southern Economic JournalAllocative Inefficiency in the Production of Hospital Services
44 Citations1991B. Kelly Eakin
Empirical results indicate that overcapitalization and underemployment of physicians increase short-term hospital costs by about 5 percent, which is almost three times the percentage in 1960 and represents a large amount in actual dollars.
Journal of Health Politics Policy and LawHospitals and Antitrust: Defining Markets, Setting Standards
40 Citations1994Jack Zwanziger, Glenn Melnick +1 more
This paper argues for a different approach to market definition in areas where insurance plans that contract selectively are a significant market presence, and some policy implications are drawn.
Socio-Economic Planning SciencesTechnical efficiency and the competitive behavior of hospitals
37 Citations1994Thomas N. Chirikos, Alan M. Sear
Empirical analysis of acute-care hospitals in the State of Florida in 1989 shows that these ratings are systematically accounted for by both the nature and vigor of hospital competition, with price leaders in highly competitive markets in particular shown to be more efficient.
The Antitrust BulletinThe Herfindahl-Hirschman Index as a Market Structure Variable: An Exposition for Antitrust Practitioners
36 Citations1982Richard A. Miller
Journal of Health Politics Policy and LawFederal Antitrust Merger Enforcement Standards: A Good Fit for the Hospital Industry?
23 Citations1995Gloria J. Bazzoli, David B. Marx +2 more
It is found that the specific standards articulated in the merger guidelines do not provide good predictability of when a hospital merger challenge would occur, and comparisons of challenged and unchallenged mergers in similarly structured markets suggest that enforcement actions may deviate in practice from the enforcement principles of the merger Guidelines.
Review of Industrial OrganizationCompetition and the performance of hospital markets
18 Citations1984Philip L. Hersch
The model indicates that monopoly power leads to higher quality-adjusted hospital prices, resulting in a reduction in the level of hospital resources consumed, which can occur through admissions, patient length of stay, or resources consumed per patient-day.
Review of Industrial OrganizationAn antitrust analysis of non-profit hospital mergers
16 Citations1993Erwin A. Blackstone, Joseph P. Fuhr
Outpatient services are found to comprise a separate market from inpatient hospital services, and non-profit status is determined to warrant the usual antitrust merger treatment.
Health Care Management ReviewHospital markets and competition: Implications for antitrust policy
9 Citations1994Nguyen Xuan Nguyen, Frederick W. Derrick
The findings are consistent with the hypothesis that hospitals compete primarily on a nonprice basis and suggest that a more flexible application of antitrust policy to hospital mergers will reduce cost increases and will improve efficiency.
Atlantic Economic JournalThe problem of geographic market definition: Geographic proximity vs. economic significance
7 Citations1991Steven E Crane, Patrick J. Welch