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The Impact of Market Environment on Excess Capacity and the Cost of an Empty Hospital Bed

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  • Jon Magnussen
  • Lee Rivers Mobley

Abstract

The health economics literature contains contradictory empirical findings regarding the cost of an empty hospital bed. Recent empirical studies which account for the endogeneity of reserve capacity produce high estimates of these costs, while earlier studies and industry experts maintain that empty beds are cheap. This paper provides evidence which helps to reconcile the controversy. The cost of excess bed capacity will depend upon staffing levels of different types of labor in the hospital. We provide a relationship between capacity utilization, productive efficiency, and the cost of empty beds, and then compare the utilization of bed capacity in four very different market environments. These are the highly regulated, public Norwegian hospitals, who face very little competitive pressure, and the unregulated, private California hospitals, divided into three groups with variation in ownership and competitive environment. We find considerable variation in input utilization and excess capacity, with different implications for the cost of empty beds across the hospital groups and their respective market environments. Our findings suggest that the cost of an empty bed varies with market conditions, hence the seemingly contradictory findings in the literature are to be expected. Our findings also suggest an interesting area of future research: the impact of managed care on reserve capacity in hospitals.

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  • Jon Magnussen & Lee Rivers Mobley, 1999. "The Impact of Market Environment on Excess Capacity and the Cost of an Empty Hospital Bed," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 6(3), pages 383-398.
  • Handle: RePEc:taf:ijecbs:v:6:y:1999:i:3:p:383-398
    DOI: 10.1080/13571519984142
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    References listed on IDEAS

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    1. Keeler, Theodore E & Ying, John S, 1996. "Hospital Costs and Excess Bed Capacity: A Statistical Analysis," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 470-481, August.
    2. Paul L. Joskow, 1980. "The Effects of Competition and Regulation on Hospital Bed Supply and the Reservation Quality of the Hospital," Bell Journal of Economics, The RAND Corporation, vol. 11(2), pages 421-447, Autumn.
    3. Jensen, Gail A & Morrisey, Michael A, 1986. "The Role of Physicians in Hospital Production," The Review of Economics and Statistics, MIT Press, vol. 68(3), pages 432-442, August.
    4. Gaynor, Martin & Anderson, Gerard F., 1995. "Uncertain demand, the structure of hospital costs, and the cost of empty hospital beds," Journal of Health Economics, Elsevier, vol. 14(3), pages 291-317, August.
    5. Iversen, Tor, 1993. "A theory of hospital waiting lists," Journal of Health Economics, Elsevier, vol. 12(1), pages 55-71, April.
    6. Roger Feldman & Felix Lobo, 1997. "Global Budgets and Excess Demand for Hospital Care," Health Economics, John Wiley & Sons, Ltd., vol. 6(2), pages 187-196, March.
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    Cited by:

    1. Lukas Steinmann & Gunnar Dittrich & Alexander Karmann & Peter Zweifel, 2004. "Measuring and comparing the (in)efficiency of German and Swiss hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(3), pages 216-226, September.
    2. Giovanni Cesaroni & Kristiaan Kerstens & Ignace Van de Woestyne, 2017. "A New Input-Oriented Plant Capacity Notion: Definition and Empirical Comparison," Pacific Economic Review, Wiley Blackwell, vol. 22(4), pages 720-739, October.
    3. Roxani Karagiannis, 2015. "A system-of-equations two-stage DEA approach for explaining capacity utilization and technical efficiency," Annals of Operations Research, Springer, vol. 227(1), pages 25-43, April.
    4. Björn A. Kuchinke & Ansgar Wübker, 2009. "Defizite von öffentlichen Allgemeinkrankenhäusern in Deutschland: Empirische Befunde von 1998 bis 2004 und wirtschaftspolitische Implikationen," Perspektiven der Wirtschaftspolitik, Verein für Socialpolitik, vol. 10(3), pages 290-308, August.
    5. Linna, Miika & Hakkinen, Unto & Magnussen, Jon, 2006. "Comparing hospital cost efficiency between Norway and Finland," Health Policy, Elsevier, vol. 77(3), pages 268-278, August.
    6. Gunnar Dittrich & Alexander Karmann & Lukas Steinmann & Peter Zweifel, 2005. "Effiziente Krankenhäuser? : ein Vergleich sächsischer und schweizerischer Krankenhäuser," ifo Dresden berichtet, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 12(02), pages 9-18, 04.
    7. Cesaroni, Giovanni & Kerstens, Kristiaan & Van de Woestyne, Ignace, 2019. "Short- and long-run plant capacity notions: Definitions and comparison," European Journal of Operational Research, Elsevier, vol. 275(1), pages 387-397.
    8. Kerstens, Kristiaan & Shen, Zhiyang, 2021. "Using COVID-19 mortality to select among hospital plant capacity models: An exploratory empirical application to Hubei province," Technological Forecasting and Social Change, Elsevier, vol. 166(C).
    9. Gunnar Dittrich & Alexander Karmann & Lukas Steinmann & Peter Zweifel, 2005. "Effiziente Krankenhäuser? : ein Vergleich sächsischer und schweizerischer Krankenhäuser," ifo Dresden berichtet, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 12(02), pages .9-18, April.

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