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What Does Canada Profit from the For-Profit Debate on Health Care?

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Author Info
Gillian Currie
Cam Donaldson
Mingshan Lu

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Abstract

This paper explores the relevance of the literature on for-profit versus not-for-profit hospital care to the Alberta government's Health Care Protection Act and to contracting-out of health services more generally. Thirty-four studies were identified and most found no difference between for-profit and not-for-profit full- service hospitals with respect to relative costs, quality of care or efficiency - a conclusion that is contrary to more selective reviews of this literature. Further assessment of the content and context of this literature leads us to argue that this "evidence" is irrelevant to Canadian health care and, therefore, the debate on contracting-out.

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File URL: http://economics.ca/cgi/jab?journal=cpp&view=v29n2/CPPv29n2p227.pdf
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Publisher Info
Article provided by University of Toronto Press in its journal Canadian Public Policy.

Volume (Year): 29 (2003)
Issue (Month): 2 (June)
Pages: 227-251
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Handle: RePEc:cpp:issued:v:29:y:2003:i:2:p:227-251

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

  1. George W. Wilson & Joseph M. Jadlow, 1982. "Competition, Profit Incentives, and Technical Efficiency in the Provision of Nuclear Medicine Services," Bell Journal of Economics, The RAND Corporation, vol. 13(2), pages 472-482, Autumn. [Downloadable!] (restricted)
  2. Frank A. Sloan & Gabriel A. Picone & Donald H. Taylor, Jr. & Shin-Yi Chou, 1999. "Does Where You Are Admitted Make a Difference? An Analysis of Medicare Data," NBER Chapters, in: Frontiers in Health Policy research, volume 2, pages 1-26 National Bureau of Economic Research, Inc. [Downloadable!]
    Other versions:
  3. Mark McClellan & Douglas Staiger, 1999. "Comparing Hospital Quality at For-Profit and Not-for-Profit Hospitals," NBER Working Papers 7324, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  4. Richard Frank & David S. Salkever, 2000. "Market Forces, Diversification of Activity, and the Mission of No t-for -Profit Hospitals," NBER Chapters, in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 195-226 National Bureau of Economic Research, Inc. [Downloadable!]
  5. Bruning, Edward R & Register, Charles A, 1989. "Technical Efficiency within Hospitals: Do Profit Incentives Matter?," Applied Economics, Taylor and Francis Journals, vol. 21(9), pages 1217-33, September.
  6. Mark G. Duggan, 2000. "Hospital Ownership And Public Medical Spending," The Quarterly Journal of Economics, MIT Press, vol. 115(4), pages 1343-1373, November. [Downloadable!] (restricted)
    Other versions:
  7. Frank A. Sloan & Gabriel A. Picone & Donald H. Taylor, Jr. & Shin-Yi Chou, 1998. "Hospital Ownership and Cost and Quality of Care: Is There a Dime's Worth of Difference?," NBER Working Papers 6706, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  8. Mark Duggan, 2000. "Hospital Market Structure and the Behavior of Not-for-Profit Hospitals: Evidence from Responses to California's Disproportionate Share Program," NBER Working Papers 7966, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  9. Richard Arnould & Marianne Bertrand & Kevin F. Hallock, 2000. "Does Managed Care Change the Mission of Nonprofit Hospitals? Evidence From the Managerial Labor Market," NBER Working Papers 7924, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  10. Koop, Gary & Osiewalski, Jacek & Steel, Mark F. J., 1997. "Bayesian efficiency analysis through individual effects: Hospital cost frontiers," Journal of Econometrics, Elsevier, vol. 76(1-2), pages 77-105. [Downloadable!] (restricted)
  11. David M. Cutler & Jill R. Horwitz, 1998. "Converting Hospitals from Not-for-profit to For-profit Status," NBER Working Papers 6672, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  12. David M. Cutler & Jill Horwitz, 2000. "Converting Hospitals from No t-for-Profit to For-Profit Status Why and What Effects?," NBER Chapters, in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 45-90 National Bureau of Economic Research, Inc. [Downloadable!]
  13. Elaine Silverman & Jonathan Skinner, 2001. "Are For-Profit Hospitals Really Different? Medicare Upcoding and Market Structure," NBER Working Papers 8133, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  14. Becker, Edmund R & Sloan, Frank A, 1985. "Hospital Ownership and Performance," Economic Inquiry, Oxford University Press, vol. 23(1), pages 21-36, January.
  15. Robinson, James C. & Luft, Harold S., 1985. "The impact of hospital market structure on patient volume, average length of stay, and the cost of care," Journal of Health Economics, Elsevier, vol. 4(4), pages 333-356, December. [Downloadable!] (restricted)
  16. Donald F. Vitaliano & Mark Toren, 1996. "Hospital Cost and Efficiency in a Regime of Stringent Regulation," Eastern Economic Journal, Eastern Economic Association, vol. 22(2), pages 161-175, Spring. [Downloadable!]
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