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Are Patients Traveling Further?

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  • William White
  • Michael Morrisey

Abstract

Managed care has been hypothesized to increase patient travel for health care services by steering patients to more distant providers. This raises access concerns. However, if the result is to expand the geographic extent of provider markets, this may ease antitrust concerns about mergers. This research compares travel distances for patients discharged from California hospitals in 1985 and 1991 controlling for payor, diagnosis, and local market conditions. Privately insured patients were more likely to be in managed care than Medicare patients during this period. We expect travel distances to increase for private patients relative to Medicare patients if managed is leading to greater travel. However, for a random sample of patients excluding births and neonatal discharges, we find no evidence relative travel increased. Nor do we find a systematic pattern of increase when we examine travel for specific diagnoses selected on the basis of the urgency and complexity of care.

Suggested Citation

  • William White & Michael Morrisey, 1998. "Are Patients Traveling Further?," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 5(2), pages 203-221.
  • Handle: RePEc:taf:ijecbs:v:5:y:1998:i:2:p:203-221
    DOI: 10.1080/13571519884512
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    References listed on IDEAS

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    1. Laurence Baker & Joanne Spetz, 1999. "Managed Care and Medical Technology Growth," NBER Chapters, in: Frontiers in Health Policy Research, volume 2, pages 27-52, National Bureau of Economic Research, Inc.
    2. David Dranove & Mark Shanley & Carol Simon, 1992. "Is Hospital Competition Wasteful?," RAND Journal of Economics, The RAND Corporation, vol. 23(2), pages 247-262, Summer.
    3. Joy Grossman & Dwayne Banks, 1998. "Unrestricted Entry and Nonprice Competition: The Case of Technological Adoption in Hospitals," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 5(2), pages 223-245.
    4. Kohn, Meir G. & Shavell, Steven, 1974. "The theory of search," Journal of Economic Theory, Elsevier, vol. 9(2), pages 93-123, October.
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    Cited by:

    1. Meneses, Francisco & Urzua, Sergio & Paredes, Ricardo & Chumacero, Romulo, 2010. "Distance to School and Competition in the Chilean Schooling System," MPRA Paper 66573, University Library of Munich, Germany.
    2. Frech, Ted E, 1998. "Managed Care, Distance Traveled, and Hospital Market Definition," University of California at Santa Barbara, Economics Working Paper Series qt84x5q49q, Department of Economics, UC Santa Barbara.

    More about this item

    Keywords

    Patient Travel; Market Definition; Antitrust;

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