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The Effects of Competition and Regulation on Hospital Bed Supply and the Reservation Quality of the Hospital

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Paul L. Joskow

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Abstract

This article uses a simple queuing model to examine several factors that affect hospital bed supply decisions and the reservation quality of the hospital. The model takes account of demand uncertainty, the internal organization of the hospital, nonprice competition among hospitals, and hospital regulation. The empirical work indicates that hospital reserve margins vary directly with the extent of interhospital competition and inversely with the intensity of hospital regulation. Estimates of the reservation quality of the hospital are shown to depend critically on assumptions about internal organization of hospitals and the ways in which hospital utilization varies over the year.

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File URL: http://links.jstor.org/sici?sici=0361-915X%28198023%2911%3A2%3C421%3ATEOCAR%3E2.0.CO%3B2-J&origin=repec
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Publisher Info
Article provided by The RAND Corporation in its journal Bell Journal of Economics.

Volume (Year): 11 (1980)
Issue (Month): 2 (Autumn)
Pages: 421-447
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Handle: RePEc:rje:bellje:v:11:y:1980:i:autumn:p:421-447

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  1. Joan Bloom & Jeffrey Alexander & Beverly Nuchols, 1993. "Staffing Patterns and Hospital Efficiency," Institute for Research on Labor and Employment, Working Paper Series 1080, Institute of Industrial Relations, UC Berkeley. [Downloadable!]
  2. Paul J. Gertler & Donald M. Waldman, 1990. "Quality Adjusted Cost Functions," NBER Working Papers 3567, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  3. Martin Gaynor, 2006. "What Do We know About Competition and Quality in Health Care Markets?," The Centre for Market and Public Organisation 06/151, Department of Economics, University of Bristol, UK. [Downloadable!]
    Other versions:
  4. José J. Escarce & Arvind K. Jain & Jeannette Rogowski, 2006. "Hospital Competition, Managed Care and Mortality After Hospitalization for Medical Conditions: Evidence From Three States," NBER Working Papers 12335, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  5. Jeffrey Alexander & Joan Bloom & Beverly Nuchols, 1991. "Nursing Turnover and Hospital Efficiency: An Organization Level Analysis," Institute for Research on Labor and Employment, Working Paper Series 1051, Institute of Industrial Relations, UC Berkeley. [Downloadable!]
  6. Daniel P. Kessler & Mark B. McClellan, 1999. "Is Hospital Competition Socially Wasteful?," NBER Working Papers 7266, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  7. Laurie Bates & Rexford Santerre, 2008. "Do health insurers possess monopsony power in the hospital services industry?," International Journal of Health Care Finance and Economics, Springer, vol. 8(1), pages 1-11, March. [Downloadable!] (restricted)
  8. Jon Magnussen, Lee Rivers Mobley, 1999. "The Impact of Market Environment on Excess Capacity and the Cost of an Empty Hospital Bed," International Journal of the Economics of Business, Taylor and Francis Journals, vol. 6(3), pages 383-398, November. [Downloadable!] (restricted)
  9. Andrew Street & Jane Haycock, 1999. "The economic consequences of reorganizing hospital services in Bishkek, Kyrgyzstan," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 53-64.
  10. 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. [Downloadable!] (restricted)
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  11. Daniel Kessler & Mark McClellan, 1999. "Designing Hospital Antitrust Policy to Promote Social Welfare," NBER Working Papers 6897, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  12. Martin Gaynor & Gerard F. Anderson, 1995. "Uncertain Demand, The Structure of Hospital Costs, and the Cost of EmptyHospital Beds," NBER Working Papers 4460, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  13. Rexford E. Santerre & John A. Vernon, 2005. "Hospital Ownership Mix Efficiency in the US: An Exploratory Study," NBER Working Papers 11192, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  14. Anil Bamezai & Jack Zwanziger & Glenn A. Melnick & Joyce M. Mann, 1999. "Price competition and hospital cost growth in the United States (1989-1994)," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 233-243.
  15. David Meltzer & Jeanette Chung, 2002. "Effects of Competition Under Prospective Payment on Hospital Costs Among High- and Low-Cost Admissions: Evidence from California, 1983 and 1993," Forum for Health Economics & Policy, Berkeley Electronic Press, vol. 5(1), pages 1029-1029. [Downloadable!] (restricted)
  16. Carmen Herrero Blanco & Paula González, 2001. "Optimal Sharing Of Surgical Costs In The Presence Of Queues," Working Papers. Serie AD 2001-27, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie). [Downloadable!]
  17. Rexford E. Santerre & Dana C. Bennett, 1992. "Hospital Market Structure and Cost Performance: A Case Study," Eastern Economic Journal, Eastern Economic Association, vol. 18(2), pages 209-219, Spring. [Downloadable!]
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