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Demand for and Regulation of Cardiac Services

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  • Justin G. Trogdon

    (School of Economics, University of Adelaide)

Abstract

Efforts to regionalize cardiac services can increase access costs for patients. This study quantifies this trade off by estimating the effects of changes in the regulation of hospital services on treatments and outcomes. A demand model for surgery services is specified in which heart attack victims form expectations of the need for and productivity of surgery in their choice of hospital and treatment. The results indicate that mortality is relatively insensitive to moderate changes in policy: changes in travel costs and volume offset one another. Despite similar health outcomes, the competing policies have different implications for taxpayers.

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Bibliographic Info

Paper provided by EconWPA in its series HEW with number 0502001.

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Date of creation: 03 Feb 2005
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Handle: RePEc:wpa:wuwphe:0502001

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Web page: http://128.118.178.162

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Keywords: heart attack; Medicare; dynamic discrete choice estimation;

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  1. Heckman, James & Singer, Burton, 1984. "A Method for Minimizing the Impact of Distributional Assumptions in Econometric Models for Duration Data," Econometrica, Econometric Society, vol. 52(2), pages 271-320, March.
  2. repec:att:wimass:9430 is not listed on IDEAS
  3. Justin G. Trogdon, 2004. "Regionalization of Cardiac Services and the Responsiveness of Treatment Choices," HEW 0411001, EconWPA.
  4. Dranove, David & White, William D, 1994. "Recent Theory and Evidence on Competition in Hospital Markets," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 169-209, Spring.
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  8. Susan Athey & Scott Stern, 2000. "The Adoption and Impact of Advanced Emergency Response Services," NBER Chapters, in: The Changing Hospital Industry: Comparing For-Profit and Not-for-Profit Institutions, pages 113-168 National Bureau of Economic Research, Inc.
  9. Peter Arcidiacono & John Bailey Jones, 2003. "Finite Mixture Distributions, Sequential Likelihood and the EM Algorithm," Econometrica, Econometric Society, vol. 71(3), pages 933-946, 05.
  10. Michael P. Keane & Kenneth I. Wolpin, 1994. "The solution and estimation of discrete choice dynamic programming models by simulation and interpolation: Monte Carlo evidence," Staff Report 181, Federal Reserve Bank of Minneapolis.
  11. Barton H. Hamilton & Vivian H. Hamilton, 1997. "Estimating surgical volume-outcome relationships applying survival models: accounting for frailty and hospital fixed effects," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 383-395.
  12. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 577-615, May.
  13. McGuire, Thomas G., 2000. "Physician agency," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 9, pages 461-536 Elsevier.
  14. Hodgkin, Dominic, 1996. "Specialized service offerings and patients' choice of hospital: The case of cardiac catheterization," Journal of Health Economics, Elsevier, vol. 15(3), pages 305-332, June.
  15. Dranove, David & Satterthwaite, Mark A., 2000. "The industrial organization of health care markets," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 20, pages 1093-1139 Elsevier.
  16. Dracup, Kathleen & Moser, Debra K. & Eisenberg, Mickey & Meischke, Hendrika & Alonzo, Angelo A. & Braslow, Allan, 1995. "Causes of delay in seeking treatment for heart attack symptoms," Social Science & Medicine, Elsevier, vol. 40(3), pages 379-392, February.
  17. Donna B. Gilleskie, 1998. "A Dynamic Stochastic Model of Medical Care Use and Work Absence," Econometrica, Econometric Society, vol. 66(1), pages 1-46, January.
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