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Quality Choice And Market Structure: A Dynamic Analysis Of Nursing Home Oligopolies


  • Haizhen Lin


This article develops a dynamic model of entry and exit to analyze quality choice and oligopoly market structure in the nursing home industry. I find significant heterogeneity in the competitive effects across market structures: Firms of similar quality levels compete more strongly than dissimilar firms. Sunken entry costs are extremely large, and quality adjustment behavior is governed by significant fixed adjustment costs. A proposal to eliminate low‐quality nursing homes is found to cause a large supply‐side shortage, and another proposal to lower entry costs has offered a perverse incentive to provide low quality of care.

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  • Haizhen Lin, 2015. "Quality Choice And Market Structure: A Dynamic Analysis Of Nursing Home Oligopolies," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 56, pages 1261-1290, November.
  • Handle: RePEc:wly:iecrev:v:56:y:2015:i::p:1261-1290

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    Cited by:

    1. Shinya Sugawara, 2017. "Firm‐Driven Management of Longevity Risk: Analysis of Lump‐Sum Forward Payments in Japanese Nursing Homes," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 26(1), pages 169-204, February.
    2. Martin B. Hackmann, 2019. "Incentivizing Better Quality of Care: The Role of Medicaid and Competition in the Nursing Home Industry," American Economic Review, American Economic Association, vol. 109(5), pages 1684-1716, May.
    3. Victor Aguirregabiria & Mathieu Marcoux, 2019. "Imposing equilibrium restrictions in the estimation of dynamic discrete games," Working Papers tecipa-646, University of Toronto, Department of Economics.
    4. Luan, Mengna & Shao, Xiang & Dou, Fengman, 2020. "Financial conditions, health care provision, and patient outcomes: Evidence from Chinese public hospitals," Economics Letters, Elsevier, vol. 186(C).
    5. Kalouptsidi, Myrto & Scott, Paul & Souza-Rodrigues, Eduardo, 2017. "Identification of Counterfactuals in Dynamic Discrete Choice Models," CEPR Discussion Papers 12470, C.E.P.R. Discussion Papers.

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