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Behavioural differences among hospitals: it is ownership, or location?

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Author Info
Lee Mobley
W. David Bradford

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Abstract

By about 1988, the consensus among leading health economists was that no meaningful differences existed among hospitals of differences owernership form, and this position was embraced by the Antitrust Division of the US Department of Justice. But behavioural differences among hospitals of different among hospitals of different owernership has continued to be a matter of both academic and judicial interest. Recent empirical studies have concluded that real differences do exist, while many earlier studies reached the opposite conclusion. This contradiction in finding over time, as competition intensified, is exactly opposite to what expense-preference theory would predict. We examine this apparent paradox, using a very general test of behavioural differences by hospital ownership. We find that the omission of location-specific variables can lead to biased estimates of ownership effects, and that no significant behavioural differences exist among private California hospitals in 1986--90, when this source of ownership endogeneity is eliminated.

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Article provided by Taylor and Francis Journals in its journal Applied Economics.

Volume (Year): 29 (1997)
Issue (Month): 9 (September)
Pages: 1125-1138
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Handle: RePEc:taf:applec:v:29:y:1997:i:9:p:1125-1138

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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. Sloan, Frank A. & Feldman, Roger D. & Steinwald, A. Bruce, 1983. "Effects of teaching on hospital costs," Journal of Health Economics, Elsevier, vol. 2(1), pages 1-28, March. [Downloadable!] (restricted)
  2. Noether, Monica, 1986. "The Growing Supply of Physicians: Has the Market Become More Competitive?," Journal of Labor Economics, University of Chicago Press, vol. 4(4), pages 503-37, October. [Downloadable!] (restricted)
  3. Oliver D. Hart, 1983. "The Market Mechanism as an Incentive Scheme," Bell Journal of Economics, The RAND Corporation, vol. 14(2), pages 366-382, Autumn. [Downloadable!] (restricted)
  4. Danzon, Patricia Munch, 1982. "Hospital `profits' : The effects of reimbursement policies," Journal of Health Economics, Elsevier, vol. 1(1), pages 29-52, May. [Downloadable!] (restricted)
  5. Frech, H E, III, 1976. "The Property Rights Theory of the Firm: Empirical Results from a Natural Experiment," Journal of Political Economy, University of Chicago Press, vol. 84(1), pages 143-52, February. [Downloadable!] (restricted)
  6. Feldman, Roger & Dowd, Bryan, 1986. "Is there a competitive market for hospital services?," Journal of Health Economics, Elsevier, vol. 5(3), pages 277-292, September. [Downloadable!] (restricted)
  7. Breyer, Friedrich, 1987. "The specification of a hospital cost function : A comment on the recent literature," Journal of Health Economics, Elsevier, vol. 6(2), pages 147-157, June. [Downloadable!] (restricted)
  8. Becker, Edmund R & Sloan, Frank A, 1985. "Hospital Ownership and Performance," Economic Inquiry, Oxford University Press, vol. 23(1), pages 21-36, January.
  9. Edward C. Norton & Douglas O. Staiger, 1994. "How Hospital Ownership Affects Access to Care for the Uninsured," RAND Journal of Economics, The RAND Corporation, vol. 25(1), pages 171-185, Spring. [Downloadable!] (restricted)
  10. Register, Charles A. & Sharp, Ansel M., 1989. "For-profit hospital performance: The impact of time," Journal of Behavioral Economics, Elsevier, vol. 18(4), pages 307-316. [Downloadable!] (restricted)
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  1. Massimo Filippini, 1999. "Economies Of Scale In The Swiss Nursing Home Industry," Working Papers 9901, University of Zurich, Socioeconomic Institute. [Downloadable!]
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