Assessing competition in hospital care markets: the importance of accounting for quality differentiation
Assessing competition in hospital care markets: the importance of accounting for quality differentiation
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DOI：
10.2307/1593788
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发表时间：
2003-12-01
影响因子：
2.3
通讯作者：
Tay, A
中科院分区：
文献类型：
--
作者：
Tay, A
在医院行业，质量差异化尤其重要，因为医疗保险患者的选择不受价格的影响。与以前使用地理市场集中度来评估医院竞争力的研究不同，本文强调了在这个空间差异化的市场中质量差异化的重要性。我估计了一个随机系数离散选择模型，该模型预测了前往不同医院的患者流量，发现需求对距离和质量的反应都很大。这些估计表明，患者没有按照当前市场份额的比例转向替代医院，这意味着地理市场集中度不是衡量医院竞争力的适当指标。
Quality differentiation is especially important in the hospital industry, where the choices of Medicare patients are unaffected by prices. Unlike previous studies that use geographic market concentration to estimate hospital competitiveness, this article emphasizes the importance of quality differentiation in this spatially differentiated market. I estimate a random-coefficients discrete-choice model that predicts patient flow to different hospitals and find that demand responses to both distance and quality are substantial. The estimates suggest that patients do not substitute toward alternative hospitals in proportion to current market shares, implying that geographic market concentration is an inappropriate measure of hospital competitiveness.