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Does competition from ambulatory surgical centers affect hospital surgical output?

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Author Info

  • Courtemanche, Charles
  • Plotzke, Michael

Abstract

This paper estimates the effect of ambulatory surgical centers (ASCs) on hospital surgical volume using hospital and year fixed effects models with several robustness checks. We show that ASC entry only appears to influence a hospital's outpatient surgical volume if the facilities are within a few miles of each other. Even then, the average reduction in hospital volume is only 2-4%, which is not nearly large enough to offset the new procedures performed by an entering ASC. The effect is, however, stronger for large ASCs and the first ASCs to enter a market. Additionally, we find no evidence that entering ASCs reduce a hospital's inpatient surgical volume.

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Bibliographic Info

Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 29 (2010)
Issue (Month): 5 (September)
Pages: 765-773

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Handle: RePEc:eee:jhecon:v:29:y:2010:i:5:p:765-773

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Web page: http://www.elsevier.com/locate/inca/505560

Related research

Keywords: Ambulatory surgical center Hospital competition Physician-ownership Hospital profit;

References

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  1. Jean M. Abraham & Martin S. Gaynor & William B. Vogt, 2005. "Entry and Competition in Local Hospital Markets," NBER Working Papers 11649, National Bureau of Economic Research, Inc.
  2. Douglas Staiger & James H. Stock, 1994. "Instrumental Variables Regression with Weak Instruments," NBER Technical Working Papers 0151, National Bureau of Economic Research, Inc.
  3. Leemore S. Dafny, 2005. "Games Hospitals Play: Entry Deterrence in Hospital Procedure Markets," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 14(3), pages 513-542, 09.
  4. Jon R. Gabel & Cheryl Fahlman & Ray Kang & Gregory Woznlak & Phil Kletke & Joel W. Hay, 2008. "Where Do I Send Thee? Does Physician-Ownership Affect Referral Patterns to Ambulatory Surgery Centers?," Mathematica Policy Research Reports 6029, Mathematica Policy Research.
  5. Jason R. Barro & Robert S. Huckman & Daniel P. Kessler, 2005. "The Effects of Cardiac Specialty Hospitals on the Cost and Quality of Medical Care," NBER Working Papers 11707, National Bureau of Economic Research, Inc.
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Cited by:
  1. Dewenter, Ralf & Jaschinski, Thomas & Kuchinke, Björn A., 2012. "Hospital market concentration and discrimination of patients," DICE Discussion Papers 63, Heinrich‐Heine‐Universität Düsseldorf, Düsseldorf Institute for Competition Economics (DICE).

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