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The impacts of ownership, competitio...

Zhou, Zhu-Qin.

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The impacts of ownership, competition, and managed care on hospital performance: Evidence from Medicare.

Record Type:	Electronic resources : Monograph/item
Title/Author:	The impacts of ownership, competition, and managed care on hospital performance: Evidence from Medicare./
Author:	Zhou, Zhu-Qin.
Description:	116 p.
Notes:	Source: Dissertation Abstracts International, Volume: 65-09, Section: A, page: 3509.
Contained By:	Dissertation Abstracts International65-09A.
Subject:	Economics, Labor. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3145589
ISBN:	0496045512

The impacts of ownership, competition, and managed care on hospital performance: Evidence from Medicare.
Zhou, Zhu-Qin.

The impacts of ownership, competition, and managed care on hospital performance: Evidence from Medicare. - 116 p.

Source: Dissertation Abstracts International, Volume: 65-09, Section: A, page: 3509.

Thesis (Ph.D.)--Stanford University, 2004.

Using Medicare claims and enrollment data on colorectal cancer patients, this paper studies the impacts of ownership, competition, and managed care on hospital performance as measured by patients' one-year hospital expenditures and one-, three-, and five-year mortality rates. In so doing, I construct instrumental variables for hospitals' ownership status based on patients' distances to hospitals of different ownership types, and measure hospital markets' competitiveness on the basis of projected probabilities of admission of each patient to every hospital within her choice set.

ISBN: 0496045512Subjects--Topical Terms:

1019135
Economics, Labor.

The impacts of ownership, competition, and managed care on hospital performance: Evidence from Medicare.
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100 1 $a Zhou, Zhu-Qin. $3 1931181
245 1 4 $a The impacts of ownership, competition, and managed care on hospital performance: Evidence from Medicare.
300 $a 116 p.
500 $a Source: Dissertation Abstracts International, Volume: 65-09, Section: A, page: 3509.
500 $a Advisers: John B. Shoven; Laurence Baker.
502 $a Thesis (Ph.D.)--Stanford University, 2004.
520 $a Using Medicare claims and enrollment data on colorectal cancer patients, this paper studies the impacts of ownership, competition, and managed care on hospital performance as measured by patients' one-year hospital expenditures and one-, three-, and five-year mortality rates. In so doing, I construct instrumental variables for hospitals' ownership status based on patients' distances to hospitals of different ownership types, and measure hospital markets' competitiveness on the basis of projected probabilities of admission of each patient to every hospital within her choice set.
520 $a Estimations without using instruments show that private for-profit hospitals spend less, and public hospitals spend more, than private non-profit hospitals, and public hospitals have higher mortality rates than private for-profit and non-profit hospitals. After correcting the endogeneity problem by using instrumental variables, however, the magnitudes of the effects of ownership on expenditures become smaller, and the effect of public ownership on mortality becomes statistically insignificant.
520 $a Estimations using the unbiased HHI measures show that very high level of hospital competition is positively related to patients' one-year expenditures, but has no discernible effects on patients' mortality rates. By contrast, there are no significant differences in either expenditures or mortalities between hospitals in moderately concentrated markets and hospitals in highly concentrated markets.
520 $a My estimations also indicate that managed care penetration, proxied by the Medicare HMO enrollment rate, significantly decreases fee-for-service patients' one-year expenditures, but does not affect the mortalities of those patients. Moreover, this spillover effect of managed care on fee-for-service patients is smaller in magnitude in highly competitive fee-for-service markets.
520 $a The findings of this dissertation shed new lights on various theories on the effects of ownership, competition, and managed care on the performance of hospitals, and have important policy implications. The findings of the dissertation will be presented and discussed in connection with those theories and policy implications.
590 $a School code: 0212.
650 4 $a Economics, Labor. $3 1019135
650 4 $a Health Sciences, Health Care Management. $3 1017922
650 4 $a Sociology, Public and Social Welfare. $3 1017909
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790 1 0 $a Baker, Laurence, $e advisor
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791 $a Ph.D.
792 $a 2004
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3145589