Is hospital competition socially wasteful?
Is hospital competition socially wasteful?
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DOI：
10.1162/003355300554863
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发表时间：
2000-05-01
影响因子：
13.7
通讯作者：
McClellan, MB
中科院分区：
文献类型：
--
作者：
Kessler, DP;McClellan, MB
我们研究了1985年至1994年间医院竞争对医疗保险受益人心脏病发作护理的影响。我们研究了医院选择的相对外生决定因素（如旅行距离）如何影响医院市场的竞争力，以及医院竞争如何与管理式医疗组织的影响相互作用，从而影响社会福利支出对治疗和患者健康结果的关键决定因素。在20世纪80年代，竞争对福利的影响是模糊的；但在20世纪90年代，竞争无疑改善了社会福利。在样本期间，HMO注册人数的增加部分解释了医院竞争影响的巨大变化。
We study the consequences of hospital competition for Medicare beneficiaries' heart attack care from 1985 to 1994. We examine how relatively exogenous determinants of hospital choice such as travel distances influence the competitiveness of hospital markets, and how hospital competition interacts with the influence of managed-care organizations to affect the key determinants of social welfare-expenditures on treatment and patient health outcomes. In the 1980s the welfare effects of competition were ambiguous; but in the 1990s competition unambiguously improves social welfare. Increasing HMO enrollment over the sample period partially explains the dramatic change in the impact of hospital competition.