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Integration and Task Allocation: Evidence from Patient Care

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  • Guy David
  • Evan Rawley
  • Daniel Polsky

Abstract

We develop a formal model to show how integration solves task allocation problems between organizations and test the predictions of the model, using a large and rich patient-level dataset on hospital discharges to nursing homes and home health care. As predicted by the theory, we find that vertical integration allows hospitals to shift patient recovery tasks downstream to lower cost delivery systems by discharging patients earlier and in poorer health, and integration leads to greater post-hospitalization service intensity. While integration facilitates a shift in the allocation of tasks, health outcomes are no worse when patients receive care from an integrated provider. The evidence suggests that by improving the allocation of tasks, integration solves coordination problems that arise in market exchange.

Suggested Citation

  • Guy David & Evan Rawley & Daniel Polsky, 2011. "Integration and Task Allocation: Evidence from Patient Care," NBER Working Papers 17419, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:17419
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    Cited by:

    1. Guy David & Evan Rawley & Daniel Polsky, 2013. "Integration and Task Allocation: Evidence from Patient Care," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 22(3), pages 617-639, September.
    2. Guilherme C. Amado & Diogo C. Ferreira & Alexandre M. Nunes, 2022. "Vertical integration in healthcare: What does literature say about improvements on quality, access, efficiency, and costs containment?," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(3), pages 1252-1298, May.
    3. Richard Hirth & David Grabowski & Zhanlian Feng & Momotazur Rahman & Vincent Mor, 2014. "Effect of nursing home ownership on hospitalization of long-stay residents: an instrumental variables approach," International Journal of Health Economics and Management, Springer, vol. 14(1), pages 1-18, March.
    4. H. Frech & Christopher Whaley & Benjamin Handel & Liora Bowers & Carol Simon & Richard Scheffler, 2015. "Market Power, Transactions Costs, and the Entry of Accountable Care Organizations in Health Care," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 47(2), pages 167-193, September.

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    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • L23 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Organization of Production

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