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Essays in Industrial Organization an...

Ding, Yu.

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Essays in Industrial Organization and Health Economics.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Essays in Industrial Organization and Health Economics./
Author:	Ding, Yu.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
Description:	142 p.
Notes:	Source: Dissertations Abstracts International, Volume: 82-03, Section: B.
Contained By:	Dissertations Abstracts International82-03B.
Subject:	Health care management. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28092317
ISBN:	9798664754872

Essays in Industrial Organization and Health Economics.
Ding, Yu.

Essays in Industrial Organization and Health Economics. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 142 p.

Source: Dissertations Abstracts International, Volume: 82-03, Section: B.

Thesis (Ph.D.)--The University of Wisconsin - Madison, 2020.

This item must not be sold to any third party vendors.

Healthcare expenditures in the United States have sharply increased during recent years. At the same time, the landscape of the healthcare industry has also changed significantly. This dissertation studies the interaction of the healthcare market structure and the prescription decisions of healthcare providers.The first chapter studies whether merging hospitals eliminate duplicate services to save costs. Hospitals seeking mergers frequently claim substantial cost savings from consolidating their services to achieve economies of scale. Using the California Patient Discharge Data and Hospital Financial Report, we employ a difference-in-differences research design to empirically explore hospitals' post-merger service relocation. We find that targets and acquirers located within 10 miles of each other reduce on average 5.1 of their duplicate services. These adjacent merging hospitals also become more specialized in services, with the volume concentration measurement (Herfindahl-Hirschman Index) across services increasing by 10%. Compared to non-consolidated services, the consolidated services experience a roughly 20% reduction of per unit patient care costs. These effects are only evident when the merging hospitals are geographically close to one another.The second chapter explores the effect of capitated payment models on physicians' treatment decisions. In response to the high cost of health care, capitated payment models have become more popular in recent years. Under capitation, physicians are paid a fixed amount per patient regardless of the services generated. This study quantifies the effects of capitated payment models on physicians' treatment decisions about patients with lower back pain in the United States. We use data from 2003 to 2006 from a large employer-sponsored health insurance claim database, and we leverage capitation variation within the plan and physician to mitigate selection concerns. We find that the treatment intensity-mainly from therapy, diagnostic testing, and drugs-of patients in a capitation system is 10% lower than otherwise similar patients under a noncapitated arrangement. We also find no evidence of increased readmission rates for patients under a capitated arrangement.

ISBN: 9798664754872Subjects--Topical Terms:

2122906
Health care management.
Subjects--Index Terms:

Antitrust

Essays in Industrial Organization and Health Economics.
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500 $a Source: Dissertations Abstracts International, Volume: 82-03, Section: B.
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520 $a Healthcare expenditures in the United States have sharply increased during recent years. At the same time, the landscape of the healthcare industry has also changed significantly. This dissertation studies the interaction of the healthcare market structure and the prescription decisions of healthcare providers.The first chapter studies whether merging hospitals eliminate duplicate services to save costs. Hospitals seeking mergers frequently claim substantial cost savings from consolidating their services to achieve economies of scale. Using the California Patient Discharge Data and Hospital Financial Report, we employ a difference-in-differences research design to empirically explore hospitals' post-merger service relocation. We find that targets and acquirers located within 10 miles of each other reduce on average 5.1 of their duplicate services. These adjacent merging hospitals also become more specialized in services, with the volume concentration measurement (Herfindahl-Hirschman Index) across services increasing by 10%. Compared to non-consolidated services, the consolidated services experience a roughly 20% reduction of per unit patient care costs. These effects are only evident when the merging hospitals are geographically close to one another.The second chapter explores the effect of capitated payment models on physicians' treatment decisions. In response to the high cost of health care, capitated payment models have become more popular in recent years. Under capitation, physicians are paid a fixed amount per patient regardless of the services generated. This study quantifies the effects of capitated payment models on physicians' treatment decisions about patients with lower back pain in the United States. We use data from 2003 to 2006 from a large employer-sponsored health insurance claim database, and we leverage capitation variation within the plan and physician to mitigate selection concerns. We find that the treatment intensity-mainly from therapy, diagnostic testing, and drugs-of patients in a capitation system is 10% lower than otherwise similar patients under a noncapitated arrangement. We also find no evidence of increased readmission rates for patients under a capitated arrangement.
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