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Reconsideration of discharge data to measure competition in the hospital industry


  • Eric Nauenberg
  • Yuri Andrijuk

    (Formerly with the Department of Statistics, State University of New York at Buffalo, Buffalo, NY, USA)

  • Matthew Eisinger

    (Formerly with the Department of Statistics, State University of New York at Buffalo, Buffalo, NY, USA)


Economists have long used state-collected discharge data to construct Hirschman-Herfindahl (HH) indices measuring hospital competition. Since data are collected to determine the facility providing the service rather than ownership, the difference between the number of reporting facilities and the number of competitors has grown over time due to mergers and networking activities. Consequently, the validity of the discharge HH methodology, as currently employed, is in doubt. Comparing the annual census of New York state acute-care hospitals by the State and the American Hospital Association (AHA), we find that it is increasingly important to account for changes in ownership when constructing such indices. Copyright © 2001 John Wiley & Sons, Ltd.

Suggested Citation

  • Eric Nauenberg & Yuri Andrijuk & Matthew Eisinger, 2001. "Reconsideration of discharge data to measure competition in the hospital industry," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 271-276.
  • Handle: RePEc:wly:hlthec:v:10:y:2001:i:3:p:271-276
    DOI: 10.1002/hec.595

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    References listed on IDEAS

    1. Keeler, Emmett B. & Melnick, Glenn & Zwanziger, Jack, 1999. "The changing effects of competition on non-profit and for-profit hospital pricing behavior," Journal of Health Economics, Elsevier, vol. 18(1), pages 69-86, January.
    2. Zwanziger, Jack & Melnick, Glenn A., 1988. "The effects of hospital competition and the Medicare PPS program on hospital cost behavior in California," Journal of Health Economics, Elsevier, vol. 7(4), pages 301-320, December.
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    Cited by:

    1. Sarv Devaraj & Rajiv Kohli, 2003. "Performance Impacts of Information Technology: Is Actual Usage the Missing Link?," Management Science, INFORMS, vol. 49(3), pages 273-289, March.
    2. Eric Nauenberg & Mahdi Alkhamisi & Yuri Andrijuk, 2004. "Simulation of a Hirschman-Herfindahl index without complete market share information," Health Economics, John Wiley & Sons, Ltd., vol. 13(1), pages 87-94.

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