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Hospital competition and financial performance: the effects of ambulatory surgery centers

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  • Kathleen Carey
  • James F. Burgess
  • Gary J. Young

Abstract

Ambulatory surgery centers (ASCs), limited‐service alternatives for treating surgery patients not requiring an overnight stay, are a health‐care service innovation that has proliferated in the U.S. and other countries in recent years. This paper examines the effects of ASC competition on revenues, costs, and profit margins of hospitals that also provided these services as a subset of their general services in Arizona, California, and Texas during the period 1997–2004. We identified all ASCs operating during the period in the 49 Dartmouth Hospital Referral Regions in the three states. The results of fixed effects models suggested that ASCs are meaningful competitors to general hospitals. We found downward pressure on revenues, costs, and profits in general hospitals associated with ASC presence. Copyright © 2010 John Wiley & Sons, Ltd.

Suggested Citation

  • Kathleen Carey & James F. Burgess & Gary J. Young, 2011. "Hospital competition and financial performance: the effects of ambulatory surgery centers," Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 571-581, May.
    • Handle: RePEc:wly:hlthec:v:20:y:2011:i:5:p:571-581
    DOI: 10.1002/hec.1617
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    References listed on IDEAS

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    1. Mitchell, Jean M. & Sass, Tim R., 1995. "Physician ownership of ancillary services: Indirect demand inducement or quality assurance?," Journal of Health Economics, Elsevier, vol. 14(3), pages 263-289, August.
    2. Barro, Jason R. & Huckman, Robert S. & Kessler, Daniel P., 2006. "The effects of cardiac specialty hospitals on the cost and quality of medical care," Journal of Health Economics, Elsevier, vol. 25(4), pages 702-721, July.
    3. Gaynor, Martin & Anderson, Gerard F., 1995. "Uncertain demand, the structure of hospital costs, and the cost of empty hospital beds," Journal of Health Economics, Elsevier, vol. 14(3), pages 291-317, August.
    4. Carey, Kathleen & Burgess, Jr, James F. & Young, Gary J., 2007. "Specialization and physician-ownership in the US hospital industry: beyond the moratorium," Health Economics, Policy and Law, Cambridge University Press, vol. 2(4), pages 409-418, October.
    5. Tong Li & Robert Rosenman, 2001. "Estimating hospital costs with a generalized Leontief function," Health Economics, John Wiley & Sons, Ltd., vol. 10(6), pages 523-538, September.
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    Cited by:

    1. Richards, Michael R. & Seward, Jonathan A. & Whaley, Christopher M., 2022. "Treatment consolidation after vertical integration: Evidence from outpatient procedure markets," Journal of Health Economics, Elsevier, vol. 81(C).
    2. Vomhof, Markus, 2016. "Hospital competition with heterogeneous patient groups: Incentives and regulation," Ruhr Economic Papers 624, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    3. Geruso, Michael & Richards, Michael R., 2022. "Trading spaces: Medicare's regulatory spillovers on treatment setting for non-Medicare patients," Journal of Health Economics, Elsevier, vol. 84(C).
    4. Munnich, Elizabeth L. & Parente, Stephen T., 2018. "Returns to specialization: Evidence from the outpatient surgery market," Journal of Health Economics, Elsevier, vol. 57(C), pages 147-167.
    5. Wang, Kai & Qin, Hu & Huang, Yun & Luo, Mengwen & Zhou, Lei, 2021. "Surgery scheduling in outpatient procedure centre with re-entrant patient flow and fuzzy service times," Omega, Elsevier, vol. 102(C).
    6. David Dranove & Christopher Ody, 2016. "Evolving Measures of Provider Market Power," American Journal of Health Economics, University of Chicago Press, vol. 2(2), pages 145-160, Spring.
    7. Whaley, Christopher M. & Brown, Timothy T., 2018. "Firm responses to targeted consumer incentives: Evidence from reference pricing for surgical services," Journal of Health Economics, Elsevier, vol. 61(C), pages 111-133.
    8. Ralf Dewenter & Thomas Jaschinski & Björn A. Kuchinke, 2013. "Hospital Market Concentration and Discrimination of Patients," Schmollers Jahrbuch : Journal of Applied Social Science Studies / Zeitschrift für Wirtschafts- und Sozialwissenschaften, Duncker & Humblot, Berlin, vol. 133(3), pages 345-374.
    9. Gökalp, E. & Gülpınar, N. & Doan, X.V., 2023. "Dynamic surgery management under uncertainty," European Journal of Operational Research, Elsevier, vol. 309(2), pages 832-844.

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