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Endogenous Hospital Regulation and Its Effects on Hospital and Non-hospital Expenditures


  • Lanning, Joyce A
  • Morrisey, Michael A
  • Ohsfeldt, Robert L


Past studies of hospital rate setting regulation conclude that mature programs have been effective in constraining hospital expenditures. However, if rate regulation is influenced by higher hospital expenditures the relationship between expenditures and rate setting is confounded. This study assesses the impact of rate setting on hospital and non-hospital expenditures using a simultaneous-equation model which separates the effects of hospital expenditures on the decision to regulate from the effects of regulation on expenditures. The simultaneous-equation results indicate that mature rate setting is associated with lower per capita health care expenditures, including hosital and non-hospital expenditures. Copyright 1991 by Kluwer Academic Publishers

Suggested Citation

  • Lanning, Joyce A & Morrisey, Michael A & Ohsfeldt, Robert L, 1991. "Endogenous Hospital Regulation and Its Effects on Hospital and Non-hospital Expenditures," Journal of Regulatory Economics, Springer, vol. 3(2), pages 137-154, June.
  • Handle: RePEc:kap:regeco:v:3:y:1991:i:2:p:137-54

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    References listed on IDEAS

    1. Gruber, Harald & Verboven, Frank, 2001. "The evolution of markets under entry and standards regulation -- the case of global mobile telecommunications," International Journal of Industrial Organization, Elsevier, vol. 19(7), pages 1189-1212, July.
    2. Kreps, David M & Wilson, Robert, 1982. "Sequential Equilibria," Econometrica, Econometric Society, vol. 50(4), pages 863-894, July.
    3. Joseph G. Altonji & Todd E. Elder & Christopher R. Taber, 2005. "Selection on Observed and Unobserved Variables: Assessing the Effectiveness of Catholic Schools," Journal of Political Economy, University of Chicago Press, vol. 113(1), pages 151-184, February.
    4. James E. Prieger, 2002. "Regulation, Innovation, and the Introduction of New Telecommunications Services," The Review of Economics and Statistics, MIT Press, vol. 84(4), pages 704-715, November.
    5. Roycroft, Trevor R., 1999. "Alternative regulation and the efficiency of local exchange carriers: evidence from the Ameritech states," Telecommunications Policy, Elsevier, vol. 23(6), pages 469-480, September.
    6. Prieger, James E, 2001. "Telecommunications Regulation and New Services: A Case Study at the State Level," Journal of Regulatory Economics, Springer, vol. 20(3), pages 285-305, November.
    7. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    8. Jerry A. Hausman, 1997. "Valuing the Effect of Regulation on New Services in Telecommunications," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 28(1997 Micr), pages 1-54.
    9. Lyon, Thomas P & Huang, Haizou, 1995. "Asymmetric Regulation and Incentives for Innovation," Industrial and Corporate Change, Oxford University Press, vol. 4(4), pages 769-776.
    10. Donald, Stephen G & Sappington, David E M, 1997. "Choosing among Regulatory Options in the United States Telecommunications Industry," Journal of Regulatory Economics, Springer, vol. 12(3), pages 227-243, November.
    11. Mailath, George J, 1987. "Incentive Compatibility in Signaling Games with a Continuum of Types," Econometrica, Econometric Society, vol. 55(6), pages 1349-1365, November.
    12. Hazlett Thomas W. & Ford George S., 2001. "The Fallacy of Regulatory Symmetry: An Economic Analysis of the 'Level Playing Field' in Cable TV Franchising Statutes," Business and Politics, De Gruyter, vol. 3(1), pages 1-27, April.
    13. Prieger, James E., 2007. "Regulatory delay and the timing of product innovation," International Journal of Industrial Organization, Elsevier, vol. 25(2), pages 219-236, April.
    14. Prager, Robin A, 1989. "The Effects of Regulatory Policies on the Cost of Debt for Electric Utilities: An Empirical Investigation," The Journal of Business, University of Chicago Press, vol. 62(1), pages 33-53, January.
    15. Yossef Spiegel & Simon Wilkie, 1996. "Investment in a New Technology as a Signal of Firm Value Under Regulatory Opportunism," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 5(2), pages 251-276, June.
    16. James Prieger, 2002. "A model for regulated product innovation and introduction with application to telecommunications," Applied Economics Letters, Taylor & Francis Journals, vol. 9(10), pages 625-629.
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    Cited by:

    1. Jill R. Horwitz & Daniel Polsky, 2015. "Cross Border Effects of State Health Technology Regulation," American Journal of Health Economics, MIT Press, vol. 1(1), pages 101-123, Winter.
    2. Jill R. Horwitz & Daniel Polsky, 2014. "Cross Border Effects of State Health Technology Regulation," NBER Working Papers 19801, National Bureau of Economic Research, Inc.
    3. Guy David & Lorens A. Helmchen & Robert A. Henderson, 2009. "Does advanced medical technology encourage hospitalist use and their direct employment by hospitals?," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 237-247.
    4. Edward Alan Miller, 2005. "State health policy making determinants, theory, and methods: A synthesis," Social Science & Medicine, Elsevier, vol. 61(12), pages 2639-2657, December.
    5. repec:eee:soceps:v:60:y:2017:i:c:p:34-48 is not listed on IDEAS
    6. Vivian Ho, 2006. "Does certificate of need affect cardiac outcomes and costs?," International Journal of Health Economics and Management, Springer, vol. 6(4), pages 300-324, December.
    7. Polsky, Daniel & David, Guy & Yang, Jianing & Kinosian, Bruce & Werner, Rachel M., 2014. "The effect of entry regulation in the health care sector: The case of home health," Journal of Public Economics, Elsevier, vol. 110(C), pages 1-14.
    8. Rexford E. Santerre & Debra Pepper, 2000. "Survivorship in the US hospital services industry," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 21(5), pages 181-189.

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