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Quality Choice And Market Structure: A Dynamic Analysis Of Nursing Home Oligopolies

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  • Haizhen Lin

Abstract

This article develops a dynamic model of entry and exit to analyze quality choice and oligopoly market structure in the nursing home industry. I find significant heterogeneity in the competitive effects across market structures: Firms of similar quality levels compete more strongly than dissimilar firms. Sunken entry costs are extremely large, and quality adjustment behavior is governed by significant fixed adjustment costs. A proposal to eliminate low‐quality nursing homes is found to cause a large supply‐side shortage, and another proposal to lower entry costs has offered a perverse incentive to provide low quality of care.

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  • Haizhen Lin, 2015. "Quality Choice And Market Structure: A Dynamic Analysis Of Nursing Home Oligopolies," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 56(4), pages 1261-1290, November.
    • Handle: RePEc:wly:iecrev:v:56:y:2015:i:4:p:1261-1290
    DOI: 10.1111/iere.12137
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    4. Martin B. Hackmann & R. Vincent Pohl & Nicolas R. Ziebarth, 2018. "Patient Versus Provider Incentives in Long Term Care," NBER Working Papers 25178, National Bureau of Economic Research, Inc.
    5. Myrto Kalouptsidi & Paul T. Scott & Eduardo Souza‐Rodrigues, 2021. "Identification of counterfactuals in dynamic discrete choice models," Quantitative Economics, Econometric Society, vol. 12(2), pages 351-403, May.
    6. Raphael Corbi & Fabio Miessi Sanches, 2022. "Church Competition, Religious Subsidies and the Rise of Evangelicalism: a Dynamic Structural Analysis," Working Papers, Department of Economics 2022_09, University of São Paulo (FEA-USP).
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    8. Jianjing Lin, 2023. "To follow the market or the parent system: Evidence from health IT adoption by hospital chains," Economic Inquiry, Western Economic Association International, vol. 61(4), pages 891-910, October.
    9. Yanfei Wang, 2022. "Competition And Multilevel Technology Adoption: A Dynamic Analysis Of Electronic Medical Records Adoption In U.S. Hospitals," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(3), pages 1357-1395, August.
    10. Susan Feng Lu & Konstantinos Serfes & Gerard Wedig & Bingxiao Wu, 2021. "Does Competition Improve Service Quality? The Case of Nursing Homes Where Public and Private Payers Coexist," Management Science, INFORMS, vol. 67(10), pages 6493-6512, October.

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