The determinants of public versus private provision of Emergency Medical Services
Competition for the provision of local public services often involves mixing private firms and public agencies. Predicting competitive outcomes therefore requires identifying the productive and strategic advantages of different organizational configurations: pure public, pure private or a public-private mix. We consider a make-versus-buy decision in a government procurement context by identifying the strength of public agencies as having an inherent advantage in accessing local infrastructure while private firms are identified as having a superior incentive to exploit returns to scale technologies due to their ability to service multiple localities. We focus on the choice of system configuration for the provision of Emergency Medical Services (EMS), a socially important service which benefits from infrastructural synergies as well as technological improvements (i.e. medical quality). We test our predictions on a panel data set of the 200 largest US cities and find that smaller cities and poorer access to hospitals favor the mixed public-private configuration in the provision of EMS.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
References listed on IDEAS
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.:
- Oliver Hart & Andrei Shleifer & Robert W. Vishny, 1997.
"The Proper Scope of Government: Theory and an Application to Prisons,"
The Quarterly Journal of Economics,
Oxford University Press, vol. 112(4), pages 1127-1161.
- Oliver Hart & Andrei Shleifer & Robert W. Vishny, 1996. "The Proper Scope of Government: Theory and an Application to Prisons," NBER Working Papers 5744, National Bureau of Economic Research, Inc.
- Oliver Hart & Andrei Shleifer & Robert Vishny, 1996. "The Proper Scope of Government: Theory and an Application to Prisons," Harvard Institute of Economic Research Working Papers 1778, Harvard - Institute of Economic Research.
- Trevor L. Brown & Matthew Potoski, 2003. "Managing contract performance: A transaction costs approach," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 22(2), pages 275-297.
- repec:hrv:faseco:30727607 is not listed on IDEAS
- Jonathan Levin & Steven Tadelis, 2007. "Contracting for Government Services: Theory and Evidence from U.S. Cities," NBER Working Papers 13350, National Bureau of Economic Research, Inc. Full references (including those not matched with items on IDEAS)