ECONOMIC ANALYSES OF HEALTH CARE FINANCING AUTHORITIES

这是一个研究医疗保健融资机构的建议--这些机构 负责代表医疗保健发行免税债券 机构职能体系 目标是（1）提供一份清单和概况 医疗保健融资机构，全国-他们的活动， 它们的筹资方法以及这些方法如何随着时间的推移而变化（1980-1991年）; 以及（2）估计融资机构特征的影响（如 第一个目标）。 在 特别是低成本发行机构， 将其与较高成本区分开来的功能/技术 将确定对应方。 中的观察单位 关于大约5，000个新医院债券的经验分析 融资（其收益用于投资于固定资产或有形资产） 1980年至1991年期间的资本）和再融资。 的 该项目的主要信息来源是关于新的 发行市政证券（新的融资和再融资） 由证券数据公司（SDC）维护， 金融机构。 在某些情况下， SDC提供的特性将补充类似的 来自数据库的关于新发行市政证券的信息 由IDD信息服务维护。 多变量回归分析 免税医院债券利率的决定因素将是 研究的重点是两个假设：（1） “竞争”参与债券发行，降低资本成本， (2)越大融资机构的“经验”越低， 资本成本。 竞争的影响将通过比较 在多个机构竞争权利的州， 发行医院债券，以支付州政府的利息费用， 单一发行机构，实际上是全州范围内的垄断。 竞争和 经验效应将被量化，如总 一个州的金融机构的数量;机构施加的限制 对承销商的选择，如所示的融资是否 代理机构规定了主承销商的选择，如果不是， 在该机构批准的名单上的主承销商数量;总数 一个机构过去进行的融资次数; 一个机构的升级、降级和违约数量 融资。

This is a proposal to study healthcare financing agencies -- the agencies responsible for issuing tax-exempt bonds on behalf of healthcare institutions. The objectives are to (1) provide an inventory and profile of healthcare financing agencies, nationally -- their activities and their financing methods and how these have changed over time (1980-1991); and (2) estimate the impact of financing agency characteristics (as developed in the first objective) on hospitals' capital costs. In particular, low cost issuing agencies and the agency and issuing features/techniques which distinguish them from their higher cost counterparts will be identified. The units of observation in the empirical analysis pertain to approximately 5,000 new hospital bond financings (whose proceeds are used to invest in fixed assets or physical capital) and refinancings for the period from 1980 through 1991. The main sources of information for the project are the database on new issues of municipal securities (new financings and refinancings) maintained by Securities Data Company (SDC) and a mail survey of the financing agencies. In certain cases information on issue characteristics provided by SDC will be supplemented with similar information from the database on new issues of municipal securities maintained by IDD Information Services. Multivariate regression analyses of the determinants of interest rate on tax-exempt hospital bonds will be conducted with a focus on two hypotheses: (1) the greater the "competition" involved in bond issues, the-lower the cost of capital, and (2) the greater. the "experience" of the financing agency, the lower the cost of capital. Impacts of competition will be assessed by comparing interest costs in states where multiple agencies compete for the right to issue a hospital's bonds to interest costs in states where there is a single issuing agency, in effect a state-wide monopoly. Competition and experience effects will be quantified with such measures as the total number of financing agencies in a state; restrictions imposed by agencies on the selection of underwriters as indicated by whether the financing agency dictates the selection of the lead underwriter and if not the number of lead underwriters on the agency's approved list; the total number of financings by an agency undertaken in the past; and the total number of upgrades, downgrades, and defaults among an agency's financings.