| 来源类型 | Working Paper
|
| 规范类型 | 报告
|
| DOI | 10.3386/w18926
|
| 来源ID | Working Paper 18926
|
| How Do Hospitals Respond to Market Entry? Evidence from A Deregulated Market for Cardiac Revascularization |
| Suhui Li; Avi Dor
|
| 发表日期 | 2013-03-28
|
| 出版年 | 2013
|
| 语种 | 英语
|
| 摘要 | Regulatory entry barriers to hospital service markets, namely Certificate of Need (CON) regulations, are enforced in many states; although no longer federally mandated, policy makers in other states are considering reinstating CON policies in tandem with service expansions mandated under the Affordable Care Act. While numerous studies have examined the impacts of CON on hospital volumes, demand responses to actual hospital entry into local hospital markets are not well understood. In this paper, we empirically examine the demand-augmenting, demand-redistribution, and risk-allocation effects of hospital entry by studying the cardiac revascularization markets in Pennsylvania, a state in which dynamic market entry occurred after repeal of CON in 1996. Our findings with respect to demand-augmentation are mixed: we find robust evidence that high entrant market share mitigated the declining incidence of coronary artery bypass graft (CABG), but it had no significant effect on the rising trend in percutaneous coronary intervention (PCI) procedures, among patients with coronary artery disease. Consequently, incumbent hospitals experienced a decrease in the likelihood of PCI due to entry, thereby indicating a shift in demand away from incumbents to entrants, namely business-stealing. Results of our analyses further indicate that entry by new cardiac surgery centers tended to sort high-severity patients into the more invasive CABG procedure and low-severity patients into the less invasive PCI procedures. Thus, from a welfare perspective our results are mixed: on the one hand, free-entry may lead to improved access rather than business stealing for CABG procedures; on the other hand, the empirical evidence is in favor of business-stealing for PCI procedures. Moreover, free-entry improves the match between underlying medical risk and treatment intensity. These findings underscore the importance of considering market-level strategic responses by hospitals when regulatory barriers to entry are rescinded. |
| 主题 | Health, Education, and Welfare
; Health
; Industrial Organization
; Antitrust
; Regulatory Economics
|
| URL | https://www.nber.org/papers/w18926
|
| 来源智库 | National Bureau of Economic Research (United States)
|
| 引用统计 |
|
| 资源类型 | 智库出版物
|
| 条目标识符 | http://119.78.100.153/handle/2XGU8XDN/576601
|
推荐引用方式
GB/T 7714 |
Suhui Li,Avi Dor. How Do Hospitals Respond to Market Entry? Evidence from A Deregulated Market for Cardiac Revascularization. 2013.
|
除非特别说明，本系统中所有内容都受版权保护，并保留所有权利。
