Unrestricted Entry and Nonprice Competition: The Case of Technological Adoption in Hospitals
Medical technology adoption is a major contributor to rising health care expenditures in the US. Multiple market failures provide incentives for hospitals to adopt technologies. Unrestricted entry may result in excess capacity and reductions in output that are inefficient with respect to cost and quality. We analyze the effects of hospital entry in the market for coronary artery bypass graft surgery on the number of procedures performed at both the market and firm levels, using California data from 1983 to 1990. We test the hypothesis that entry has differential effects on hospital output in a market with nonprice competition, depending on market structure. Results show that as the proximity of the nearest competitor increases with entry, hospital output declines. Holding distance to the nearest competitor constant, increasing the number of competitors results in a smaller, but still significant, decrease in output. When there are few incumbents nearby, however, output does not change significantly with entry, suggesting "business-augmenting" effects that result in increased physician referrals offset much of the conventional "businessstealing" effects.
Volume (Year): 5 (1998)
Issue (Month): 2 ()
|Contact details of provider:|| Web page: http://www.tandfonline.com/CIJB20|
|Order Information:||Web: http://www.tandfonline.com/pricing/journal/CIJB20|
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.:
- Weisbrod, Burton A, 1991. "The Health Care Quadrilemma: An Essay on Technological Change, Insurance, Quality of Care, and Cost Containment," Journal of Economic Literature, American Economic Association, vol. 29(2), pages 523-52, June.
- Gruber, Jonathan, 1994. "The effect of competitive pressure on charity: Hospital responses to price shopping in California," Journal of Health Economics, Elsevier, vol. 13(2), pages 183-211, July.
- N. Gregory Mankiw & Michael D. Whinston, 1986. "Free Entry and Social Inefficiency," RAND Journal of Economics, The RAND Corporation, vol. 17(1), pages 48-58, Spring.
- Pope, Gregory C., 1989. "Hospital nonprice competition and medicare reimbursement policy," Journal of Health Economics, Elsevier, vol. 8(2), pages 147-172, June.
- Dwayne A. Banks & Mary Paterson & Jeanne Wendel, 1997. "Uncompensated Hospital Care: Charitable Mission or Profitable Business Decision?," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 133-143.
- Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, vol. 6(3), pages 3-21, Summer.
- Keeler, Theodore E., 1990. "Government Policy, Individual Actions, and Safety: Some Evidence for Motor Vehicles," Department of Economics, Working Paper Series qt2qw0j3sk, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
- Hausman, Jerry & Hall, Bronwyn H & Griliches, Zvi, 1984.
"Econometric Models for Count Data with an Application to the Patents-R&D Relationship,"
Econometric Society, vol. 52(4), pages 909-38, July.
- Jerry A. Hausman & Bronwyn H. Hall & Zvi Griliches, 1984. "Econometric Models for Count Data with an Application to the Patents-R&D Relationship," NBER Technical Working Papers 0017, National Bureau of Economic Research, Inc.
- Rogerson, William P, 1994. "Choice of Treatment Intensities by a Nonprofit Hospital under Prospective Pricing," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 7-51, Spring.
- Dranove, David & Shanley, Mark, 1990. "A note on the relational aspects of hospital market definitions," Journal of Health Economics, Elsevier, vol. 8(4), pages 473-478, February.
- Pauly, Mark V & Redisch, Michael, 1973. "The Not-For-Profit Hospital as a Physicians' Cooperative," American Economic Review, American Economic Association, vol. 63(1), pages 87-99, March.
- Theodore E. Keeler., 1990. "Government Policy, Individual Actions, and Safety: Some Evidence for Motor Vehicles," Economics Working Papers 90-138, University of California at Berkeley.
- Sloan, Frank A. & Valvona, Joseph & Perrin, James M. & Adamache, Killard W., 1986. "Diffusion of surgical technology : An exploratory study," Journal of Health Economics, Elsevier, vol. 5(1), pages 31-61, March.
- Manheim, Larry M & Bazzoli, Gloria J & Sohn, Min-Woong, 1994. "Local Hospital Competition in Large Metropolitan Areas," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 143-67, Spring.
- Romeo, Anthony A. & Wagner, Judith L. & Lee, Robert H., 1984. "Prospective reimbursement and the diffusion of new technologies in hospitals," Journal of Health Economics, Elsevier, vol. 3(1), pages 1-24, April.
- Brenner, M. Harvey & Mooney, Anne, 1983. "Unemployment and health in the context of economic change," Social Science & Medicine, Elsevier, vol. 17(16), pages 1125-1138, January.
- Robinson, James C. & Luft, Harold S., 1985. "The impact of hospital market structure on patient volume, average length of stay, and the cost of care," Journal of Health Economics, Elsevier, vol. 4(4), pages 333-356, December.
When requesting a correction, please mention this item's handle: RePEc:taf:ijecbs:v:5:y:1998:i:2:p:223-245. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Michael McNulty)
If references are entirely missing, you can add them using this form.