Abstract:
:In recent years, the US health care industry has experienced a rapid growth of managed care, formation of networks, and an integration of hospitals. This paper provides new insights about the quality consequences of this dynamic in US hospital markets. I empirically investigate the impact of managed care and hospital competition on quality using in-hospital complications as quality measures. I use random and fixed effects, and instrumental variable fixed effect models using hospital panel data from up to 16 states in the 1992-1997 period. The paper has two important findings: First, higher managed care penetration increases the quality, when inappropriate utilization, wound infections and adverse/iatrogenic complications are used as quality indicators. For other complication categories, coefficient estimates are statistically insignificant. These findings do not support the straightforward view that increases in managed care penetration are associated with decreases in quality. Second, both higher hospital market share and market concentration are associated with lower quality of care. Hospital mergers have undesirable quality consequences. Appropriate antitrust policies towards mergers should consider not only price and cost but also quality impacts.
journal_name
Health Econjournal_title
Health economicsauthors
Sari Ndoi
10.1002/hec.726keywords:
subject
Has Abstractpub_date
2002-10-01 00:00:00pages
571-84issue
7eissn
1057-9230issn
1099-1050journal_volume
11pub_type
杂志文章相关文献
HEALTH ECONOMICS文献大全abstract::Health production models include participation in physical activity as an input. We investigate the relationship between participation in physical activity and health using a bivariate probit model. Participation is identified with an exclusion restriction on a variable reflecting sense of belonging to the community. ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.2900
更新日期:2014-01-01 00:00:00
abstract::Many OECD countries have replaced per-diem hospital reimbursement with lump sum payments by diagnosis-related groups. This study analyzes hospital responses to a large-scale refinement of reimbursement practices in Germany on January 1, 2006, in which regulating authorities introduce reimbursements by treatment intens...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.4204
更新日期:2020-12-23 00:00:00
abstract::Debate about the monetary value of a quality-adjusted life year (QALY) has existed in the health economics literature for some time. More recently, concern about such a value has arisen in UK health policy. This paper reports on an attempt to 'model' a willingness-to-pay-based value of a QALY from the existing value o...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1416
更新日期:2009-08-01 00:00:00
abstract::Few countries are immune to the international health care 'virus' of reform, with many countries regularly re-cycling changes that shift costs and benefits in ways that are arbitrary, inefficient and offer short term political palliation. Much of this activity has little evidence base and reveals lack of clarity in de...
journal_title:Health economics
pub_type: 杂志文章,评审
doi:10.1002/hec.1048
更新日期:2005-09-01 00:00:00
abstract::The excess female infant mortality observed in South Asia has typically been attributed to gender discrimination in the intra-household allocation of food and medical care. However, studies on child nutrition find no evidence of gender differences. A natural explanation could be that in environments of high infant mor...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1379
更新日期:2008-09-01 00:00:00
abstract::We use National Longitudinal Survey of Youth (NLSY) data to examine the effects of obesity on wages by gender. Sample means indicate that both men and women experience a persistent obesity wage penalty over the first two decades of their careers. We then control for a standard set of socioeconomic and familial variabl...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.881
更新日期:2004-09-01 00:00:00
abstract::This paper investigates the causal effect of Oportunidades, a conditional cash-transfer program in Mexico, on overweight and obesity of adolescents living in poor rural areas. Affecting youth weight was not a goal of this program. However, health economics research suggests that the provision of schooling, health info...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1773
更新日期:2011-09-01 00:00:00
abstract::The aims of this study were to analyse (1) whether informal care, provided by children or grandchildren to their elderly parents, and formal care are substitutes or complements, and (2) whether this relationship differs across Europe. The analyses were based on cross-sectional data from the newly developed SHARE (Surv...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1275
更新日期:2008-03-01 00:00:00
abstract::Laws mandating that individuals wear a seat belt have the presumed goal of reducing motor vehicle accident fatalities, but the prevailing view is that they may reduce the number of organs available. I provide a conceptual model identifying mechanisms whereby the law could either increase or decrease organ donation. Ex...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.4140
更新日期:2020-08-03 00:00:00
abstract::The objective of this paper is to analyse the impact that attribute ordering has on the relative importance of the price attribute. A discrete choice experiment was performed in order to elicit psoriasis patients' preferences for treatment. We tested for ordering effect with respect to the price attribute, and disclos...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1117
更新日期:2006-11-01 00:00:00
abstract::Percutaneous coronary interventions (PCI) on acute myocardial infarction (AMI) patients have increased substantially in the last 12-15 years because of its clinical effectiveness. The expansion of PCI treatment for AMI patients raises two questions: How did PCI utilization rates vary across European regions, and which...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3263
更新日期:2015-12-01 00:00:00
abstract::It is common to find specially constructed condition-specific health state descriptions used as the basis for benefit assessment in cost-utility analysis. For this approach to be valid it is necessary to have valid descriptors of health states. Yet the evidence demonstrating descriptive validity has been neglected in ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/(sici)1099-1050(199912)8:8<685::aid-hec472
更新日期:1999-12-01 00:00:00
abstract::Contingent valuation (CV) has been criticised for being too hypothetical, with expressed values bearing little relation to actual values. The magnitude of this divergence, however, depends upon how realistic and believable the contingent market is. This paper presents an overview of five key aspects in the constructio...
journal_title:Health economics
pub_type: 杂志文章,评审
doi:10.1002/hec.755
更新日期:2003-08-01 00:00:00
abstract::The sector wide approach (SWAp) emerged during the 1990s as a mechanism for managing aid from the multiplicity of development partners that operate in the recipient country's health, education or agricultural sectors. Health SWAps aim to give increased control to recipient governments, allowing greater domestic influe...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3170
更新日期:2016-05-01 00:00:00
abstract::This study focuses on Guizhou Province, a region with difficult geographical conditions and poor economic development, to examine the effect of rainfall shocks on contemporaneous infant health and long-run socioeconomic outcomes in China. The study results indicate that negative rainfall shocks are robustly correlated...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.4191
更新日期:2021-02-01 00:00:00
abstract::Statistical analysis of cost data is often difficult because of highly skewed data resulting from a few patients who incur high costs relative to the majority of patients. When the objective is to predict the cost for an individual patient, the literature suggests that one should choose a regression model based on the...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/1099-1050(200007)9:5<397::aid-hec527>3.0.c
更新日期:2000-07-01 00:00:00
abstract::This paper examines the effect of competition on the behaviour of Australian general practitioners. The paper represents a considerable improvement on the methods of previous studies by using a random effects probit model in a multilevel modelling framework to obtain a more robust estimate of the effect of GP density,...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/(sici)1099-1050(199711)6:6<577::aid-hec291
更新日期:1997-11-01 00:00:00
abstract::New technologies may displace existing, higher-value care under a fixed budget. Countries aim to curtail adoption of low-value technologies, for example, by installing cost-effectiveness thresholds. Our objective is to estimate the opportunity cost of hospital care to identify a threshold value for the Netherlands. To...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3946
更新日期:2019-11-01 00:00:00
abstract::Although the relationship between socioeconomic status (SES) and health is well documented for developed countries, less evidence has been presented for developing countries. The aim of this paper is to analyse this relationship at the household level for Fiji, a developing country in the South Pacific, using original...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1703
更新日期:2012-02-01 00:00:00
abstract::Discrete-time Markov chains have been successfully used to investigate treatment programs and health care protocols for chronic diseases. In these situations, the transition matrix, which describes the natural progression of the disease, is often estimated from a cohort observed at common intervals. Estimation of the ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.654
更新日期:2002-01-01 00:00:00
abstract::The origin of the obesity epidemic in developing countries is still poorly understood. It has been prominently argued that economic development provides a natural interpretation of the growth in obesity. This paper tests the main aggregated predictions of the theoretical framework to analyze obesity. Average body weig...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.2968
更新日期:2014-07-01 00:00:00
abstract::With the aging of society, issues concerning the reform of the Dutch health care system are ranked high on the political agenda. Sensible reforms of the health care system for the elderly require a thorough understanding of the health status of the old and of its dynamics preceding death. The health status of the elde...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/(sici)1099-1050(199908)8:5<441::aid-hec452
更新日期:1999-08-01 00:00:00
abstract::The goal of this paper is to measure the marginal change in facility-level costs of medical care for children under five due to an increase in service quality achieved through the integrated management of childhood illness (IMCI) strategy. Since the beneficial effects of IMCI training on child health outcomes are due ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1231
更新日期:2008-01-01 00:00:00
abstract::The 2003 Health Economics paper by Dolan, Olsen, Menzel and Richardson on 'An inquiry into the different perspectives that can be used when eliciting preferences in health' presents a conceptual framework of six perspectives along two dimensions: preferences (personal, social, and socially inclusive personal) and cont...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3480
更新日期:2017-12-01 00:00:00
abstract::In 2011, the USA had the second highest teen birth rate of any developed nation, according to the World Bank, . In an effort to lower teen pregnancy rates, several states have enacted policies requiring abstinence-based sex education. In this study, we utilize a difference-in-differences research design to analyze the...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.3315
更新日期:2017-04-01 00:00:00
abstract::Waiting times for specialist consultation and non-emergency surgery are often considered an equitable rationing mechanism in the public healthcare sector, because access to care is not based on socioeconomic status. This study tests empirically this claim using data from the Survey of Health, Ageing and Retirement in ...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1429
更新日期:2009-11-01 00:00:00
abstract::Authors of benefit-incidence analyses (BIA) have to impute subsidies using assumptions about the relationship between unobserved subsidies 'captured' by the household and what can be observed at the household and aggregate levels. This paper shows that one of the two assumptions used in BIA studies to date will necess...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1727
更新日期:2012-04-01 00:00:00
abstract::This paper analyses the evolution of pharmaceutical expenditure with respect to GDP for a group of the most important OECD economies. We find that this relationship is not stable across the sample considered (1960-2003), and heterogeneity is found in the temporal evolution of the variables and across countries. Furthe...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1317
更新日期:2008-10-01 00:00:00
abstract::A three-equation model is used to estimate the multiple effects of antiretroviral medications (ARVs) on the quality of life (QoL) of the elderly with HIV in New York City. The transmission mechanism involves the ARVs having a direct effect on QoL via the side effects of the medications and two other effects (one indir...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1774
更新日期:2012-08-01 00:00:00
abstract::This is a first effort to quantify the contribution of different factors in explaining racial difference in low birthweight rate (LBW). Mother's health, child characteristics, prenatal care, socioeconomic status (SES), and the socioeconomic and healthcare environment of mother's community are important inputs into the...
journal_title:Health economics
pub_type: 杂志文章
doi:10.1002/hec.1715
更新日期:2012-03-01 00:00:00