Hospital market concentration and discrimination of patients
In this paper we investigate the existence of a two-tier medical system in the German acute care hospital sector using data from a survey of 483 German hospitals. The focus of our analysis lies on the impact of hospital concentration on the probability of discrimination of patients with different health insurances in regard to the access to medical services. Accounting for a possible endogeneity of market structure, we find that hospitals in highly concentrated markets are less likely to pursue any differentiation among prospective patients with different health insurances. We ascribe this finding to competitive pressure in less concentrated markets. Hospitals in competitive markets are more obliged to steal business from rival hospitals by privileging profitable patients than hospitals in highly concentrated markets.
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- Tay, Abigail, 2003. " Assessing Competition in Hospital Care Markets: The Importance of Accounting for Quality Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 786-814, Winter.
- Gaynor, Martin & Vogt, William B., 2000.
"Antitrust and competition in health care markets,"
Handbook of Health Economics,
in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 27, pages 1405-1487
- Martin Gaynor & William B. Vogt, 1999. "Antitrust and Competition in Health Care Markets," NBER Working Papers 7112, National Bureau of Economic Research, Inc.
- Martin Gaynor & William B. Vogt, . "Antitrust and Competition in Health Care Markets," GSIA Working Papers 1999-E29, Carnegie Mellon University, Tepper School of Business.
- Plotzke, Michael & Courtemanche, Charles, 2009. "Does Competition from Ambulatory Surgical Centers Affect Hospital Surgical Output and Hospital Profit?," Working Papers 09-6, University of North Carolina at Greensboro, Department of Economics.
- Horwitz, Jill R. & Nichols, Austin, 2009. "Hospital ownership and medical services: Market mix, spillover effects, and nonprofit objectives," Journal of Health Economics, Elsevier, vol. 28(5), pages 924-937, September.
- repec:cup:cbooks:9780521816632 is not listed on IDEAS
- Luigi Siciliani & Steve Martin, 2007. "An empirical analysis of the impact of choice on waiting times," Health Economics, John Wiley & Sons, Ltd., vol. 16(8), pages 763-779.
- Martin Gaynor & William B Vogt, 2003.
"Competition among Hospitals,"
The Centre for Market and Public Organisation
03/087, Department of Economics, University of Bristol, UK.
- Carol Propper & Simon Burgess & Denise Gossage, 2008.
"Competition and Quality: Evidence from the NHS Internal Market 1991-9,"
Royal Economic Society, vol. 118(525), pages 138-170, 01.
- Burgess, Simon & Gossage, Denise & Propper, Carol, 2003. "Competition and Quality: Evidence from the NHS Internal Market 1991-9," CEPR Discussion Papers 4026, C.E.P.R. Discussion Papers.
- Courtemanche, Charles & Plotzke, Michael, 2010. "Does competition from ambulatory surgical centers affect hospital surgical output?," Journal of Health Economics, Elsevier, vol. 29(5), pages 765-773, September.
- Brekke, Kurt R. & Siciliani, Luigi & Straume, Odd Rune, 2008.
"Competition and waiting times in hospital markets,"
Journal of Public Economics,
Elsevier, vol. 92(7), pages 1607-1628, July.
- Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2007. "Competition and Waiting Times in Hospital Markets," CESifo Working Paper Series 2124, CESifo Group Munich.
- Brekke, Kurt Richard & Siciliani, Luigi & Straume, Odd Rune, 2007. "Competition and Waiting Times in Hospital Markets," CEPR Discussion Papers 6285, C.E.P.R. Discussion Papers.
- Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2007. "Competition and Waiting Times in Hospital Markets," NIPE Working Papers 9/2007, NIPE - Universidade do Minho.
- Lee, Kwang-soo & Chun, Ki-hong & Lee, Jung-soo, 2008. "Reforming the hospital service structure to improve efficiency: Urban hospital specialization," Health Policy, Elsevier, vol. 87(1), pages 41-49, July.
- Moulton, Brent R, 1990. "An Illustration of a Pitfall in Estimating the Effects of Aggregate Variables on Micro Unit," The Review of Economics and Statistics, MIT Press, vol. 72(2), pages 334-38, May.
- Christoph Schwierz & Achim Wübker & Ansgar Wübker & Björn Kuchinke, 2011. "Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals," The European Journal of Health Economics, Springer, vol. 12(5), pages 405-416, October.
- 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.
- Ryan Mutter & Patrick Romano & Herbert Wong, 2011. "The Effects of US Hospital Consolidations on Hospital Quality," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 18(1), pages 109-126.
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