Abstract
This chapter provides a review of work done by economists in modelling the behaviour of hospitals under competition and draws on such empirical results as are available. It is written in a non-technical fashion and later sections draw on the literature review in order to make an assessment of the kind of constraining/regulatory environment that is likely to be suitable in a National Health Service (NHS) provider market following the implementation of the White Paper Working for Patients (Department of Health, 1989).
Preview
Unable to display preview. Download preview PDF.
References
American Society of Internal Medicine (1985). The Impact of DRGs on Patient Care Washington DC
Arnould, R.J. and De Brock, L.M. (1986). Competition and market failure in the hospital industry: a review of the evidence. Medical Care Review, 43, 2, 253–292
Baumol, W.J., Panzar, J.C. and Willig, R.D. (1988). Contestable Markets and the Theory of Industry Structure, Harcourt Brace Jovanovich, New York
Brecher, C. (1984). Medicaid comes to Arizona: a first year report on AHCCS. Journal of Health Politics, Policy and Law, 9, 3, 411–425
Carter, G and Ginsburg, P. (1985). The Medicare Case Mix Index Increase: Medical Practice Changes, Ageing and DRG Creep, R-3292-HCFA, The Rand Corporation, Santa Monica
Culyer, A.J. (1988). Health Care Expenditures in Canada: Myth and Reality; Past and Future, Canadian Tax Foundation, Toronto
Davis, K. (1971). Relationships of hospital prices to costs. Applied Economics, 4, 115–125
Demsetz, H. (1968). Why regulate utilities? Journal of Law and Economics, 11, 55–66
Department of Health (DoH) (1989). Working for Patients, Cm. 555, HMSO, London
Department of Health (DoH) (1989b). Contracts for Health Services, Prices and Openness—A Discussion Document, Department of Health, London
DesHarnais, S., Kobrinski, E., Chesney, S. et al. (1987). The early effects of the prospective payment system on inpatient utilization and the quality of care. Inquiry, 24, 7–16
Evans, R.G. (1982), Health care in Canada: patterns of funding and regulations. In McLachlan, G. and Maynard, A. (eds.), The Public/Private Mix for Health, Nuffield Provincial Hospitals Trust, London, 369–424
Feder, J, Hadley, J., Zuckerman, S. (1987). How did Medicare’s prospective payment system affect hospitals? New England Journal of Medicine, 317, 867–73
Feldstein, M.S. (1974). The quantity of hospital services: an analysis of geographic variation and intertemporal change. In Perlman, M. (ed.), The Economics of Health and Medical Care, Macmillan, London, 402–419
Flood, A.B., Scott, W.R. and Ewy, W. (1984). Does practice make perfect? I: The relation between hospital volume and outcomes for selected diagnostic categories. Medical Care, 22, 98
Glaser, W.A. (1988). Politics of cost control abroad, Bulletin of the New York Academy of Medicine, 56, 107–114
Glaser, W.A. (1984). Hospital rate regulations: American and foreign comparison. Journal of Health Politics, Policy and Law, 8, 702–731
Guterman, S. and Dobson, A. (1986). Impact of the Medicare prospective payment system for hospitals. Health Care Financing Review, 7, 97–114
Hillman, D. and Christianson, J. (1984). Competitive bidding as a cost-containment strategy for indigent medical care: the implementation experience in Arizona. Journal of Health Politics, Policy and Law, 9, 427–451
Johns, L. (1985). Selective contracting in California. Health Affairs, 4, 32–48
Joskow, P.L. (1980). The effects of competition and regulation on hospital bed supply and the reservation quality of the hospital. Bell Journal of Economics, 11, 421–447
Joskow, P.L. (1983). Reimbursement policy, cost containment and non-price competition. Journal of Health Economics, 2, 167–174
Luft, H. (1980). The relation between surgical volume and mortality: An exploration of causal factors and alternative models. Medical Care, 18, 940–959.
Luft, H., Robinson, J. and Garnick, D. et al. (1986). The role of specialized services in competition among hospitals. Inquiry 23, 83–94
McCall, N. et al. (1987). Evaluation of Arizona Health Care Cost Containment System, 1984–85. Health Care Financing Review, 9, 79–90
Melnick, G.A. and Zwanziger, J. (1988). Hospital behaviour under competition and costcontainment policies. Journal of the American Medical Association, 260, 2669–2675
McLachlan, G. and Maynard, A. (eds.) (1982). The Public/Private Mix for Health, Nuffield Provincial Hospitals Trust, London
Morrisey, M., Sloan, F. and Valvona, J. (1988). Medicare prospective payment and post hospital transfers to subacute care. Medical Care, 26, 685–698
Newhouse, J.P. (1970). Towards a theory of non-profit institutions: an economic model of a hospital. American Economic Journal, 60, 64–74
OECD (1987). Financial and Delivering Health Care: A Comparative Analysis of OECD Countries, OECD, Paris
OECD (1987). Health and Pensions Policies under Economic and Demographic Constraints, OECD, Paris
Propper, C. (1989). An econometric analysis of the demand for private health insurance in England and Wales. Applied Economics, 21, 777–792
Rice, R.G. (1966). An analysis of the hospital as an economic organism. The Modern Hospital, 106, 87–91
Robinson, J. and Luft, H. (1985). The impact of hospital market structure on patient volume, average length of stay, and the cost of care. Journal of Health Economics, 4, 333–356
Robinson, J. and Luft, H. (1987). Competition and the cost of hospital care, 1972 to 1982. Journal of the American Medical Association, 257, 3241–3245
Robinson J. and Luft, H. (1988). Competition, regulation and hospital costs 1982 to 1986. Journal of the American Medical Association, 260, 2676–2681
Sager, M.A., Easterling, D.V., Kindig, D.A. and Anderson, O.W. (1989). Changes in the location of death after passage of Medicare’s Prospective payment system. New England Journal of Medicine, 320, 433–439
Shortell, S.M. and Hughes, E.F. (1988). The effects of regulation competition, and ownership on mortality rates among hospital inpatients. New England Journal of Medicine, 318, 1100–1107
U.S. Senate (1976). Cost and Utilization Control Mechanisms in Several European Health Care Systems, Report to the Committee in Finance, US Senate, February
Williams, A. (1974). The cost-benefit approach. British Medical Bulletin, 30, 252–256
Wilson, G. and Jadlow, J. (1982). Competition, profit incentives and technical efficiency in the provision of nuclear medicine services. Bell Journal of Economics, 13, 472–482
Woolley, J.M. (1989). The competitive effects of horizontal mergers in the hospital industry. Journal of Health Economics, 8, 271–291
World Health Organisation (WHO) (1981). Control of Health Care Costs in Social Security Systems, Euro Reports and Studies 55, Copenhagen
Zwanziger, J. and Melnick, G.A. (1988). The effects of hospital competition and the Medicare PPS program on hospital cost behaviour in California. Journal of Health Economics, 7, 301–320
Editor information
Editors and Affiliations
Copyright information
© 1990 The Editors and Contributors
About this chapter
Cite this chapter
Culyer, A.J., Posnett, J. (1990). Hospital Behaviour and Competition. In: Culyer, A.J., Maynard, A., Posnett, J. (eds) Competition in Health Care. Economic Issues in Health Care. Palgrave, London. https://doi.org/10.1007/978-1-349-21052-7_2
Download citation
DOI: https://doi.org/10.1007/978-1-349-21052-7_2
Publisher Name: Palgrave, London
Print ISBN: 978-0-333-55169-1
Online ISBN: 978-1-349-21052-7
eBook Packages: MedicineMedicine (R0)