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The Choice of Employment Arrangement in the Market for Hospitalist Services


  • Guy David

    () (The Wharton School, University of Pennsylvania)

  • Lorens A. Helmchen

    () (Division of Health Policy and Administration, School of Public Health, University of Illinois at Chicago)


Hospitalists specialize in the management of patients who are hospitalized. Despite a uniformity of work sites, educational backgrounds, and tasks, however, newly available survey data from the American Hospital Association and the Society of Hospital Medicine reveal substantial diversity in employment arrangements. We reconcile these observations by noting that the two principal players on the health care continuum—primary care physicians who refer their patients and hospitals who admit them—have strong but differing motives for using hospitalists. We show how strategic interaction between the two players may give rise to multiple equilibria in which either the primary care physician group or the hospital ends up being the sole employer of hospitalists in a given market. Over time, the growing infrequency of hospitalization and variation in the cost of setting up a hospitalist program may explain the shifting predominance of different employment arrangements.

Suggested Citation

  • Guy David & Lorens A. Helmchen, 2007. "The Choice of Employment Arrangement in the Market for Hospitalist Services," Southern Economic Journal, Southern Economic Association, vol. 73(3), pages 604-622, January.
  • Handle: RePEc:sej:ancoec:v:73:3:y:2007:p:604-622

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    References listed on IDEAS

    1. Sharon M. Oster & Daniel S. Hamermesh, 1998. "Aging And Productivity Among Economists," The Review of Economics and Statistics, MIT Press, vol. 80(1), pages 154-156, February.
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    7. Buchmueller, Thomas C. & Dominitz, Jeff & Lee Hansen, W., 1999. "Graduate training and the early career productivity of Ph.D. economists," Economics of Education Review, Elsevier, vol. 18(1), pages 65-77, February.
    8. Donna K. Ginther & Shulamit Kahn, 2004. "Women in Economics: Moving Up or Falling Off the Academic Career Ladder?," Journal of Economic Perspectives, American Economic Association, vol. 18(3), pages 193-214, Summer.
    9. Hansen, W Lee & Weisbrod, Burton A & Strauss, Robert P, 1978. "Modeling the Earnings and Research Productivity of Academic Economists," Journal of Political Economy, University of Chicago Press, vol. 86(4), pages 729-741, August.
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    Cited by:

    1. Richard J. Cebula, 2008. "Small Firm Size and Health Insurance: A Private Enterprise Perspective," Journal of Private Enterprise, The Association of Private Enterprise Education, vol. 24(Fall 2008), pages 51-77.
    2. Cebula, Richard, 2010. "Effects of Health Insurance and Medical Care Inflation on Voluntary Enlistment in the Army: An Empirical Study in the United States," MPRA Paper 51246, University Library of Munich, Germany.
    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.

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J23 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Demand
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations


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