The changing effects of competition on non-profit and for-profit hospital pricing behavior

Keeler, Emmett B.; Melnick, Glenn; Zwanziger, Jack

doi:10.1016/s0167-6296(98)00036-8

Cited by 206 publications

(163 citation statements)

References 20 publications

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“…In addition, Dranove and White (1994) estimated a trend beginning in the mid-1980s in which higher hospital competition lowered prices and cost of care. Similar results were found by Gaynor and Haas-Wilson (1999) and Keeler et al (1999). Mounting empirical evidence leads us to conclude that hospital competition improves quality of care and lowers cost of care and prices, thus improving patient welfare.…”

Section: Conclusion and Policy Implicationssupporting

confidence: 74%

Can Competition Save Your Life?

Schneider¹

2012

Social Welfare

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Section: Conclusion and Policy Implicationssupporting

confidence: 74%

Can Competition Save Your Life?

Schneider¹

2012

Social Welfare

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“…Ainda que este último não seja o foco da organização (KEELER;MELNICK;ZWANZIGER, 1999;DENEFFE;MASSON, 2002), deve ser esperado, uma vez que a má gestão pode levar a ausência de recursos e, consequentemente, à "morte" da entidade.…”

Section: Gestão E Qualidade Dos Serviços Hospitalaresunclassified

“…Neste ponto cabe destacar que uma coerente gestão de recursos faz-se oportuna (PAULY, 1987;MILLS;SPENCER, 2005) e até mesmo a obtenção de lucros ou superávits objetivando a perpetuidade da entidade, ainda que não seja o foco da organização (KEELER; MELNICK; ZWANZIGER, 1999;DENEFFE;MASSON, 2002). Fonseca e Ferreira (2009) destacam que, já na década de 1990, havia, no Brasil, uma preocupação dos estudiosos na área da saúde e dos responsáveis do governo no que tange a qualidade e eficiência na prestação dos serviços de saúde no setor público.…”

Section: Introductionunclassified

Eficiência Do Atendimento Do Sus Nas Microrregiões Do Estado De Santa Catarina

Politelo

Scarpin

2013

RAHIS

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RESUMOO objetivo deste estudo é avaliar a questão da eficiência do atendimento do SUS das vinte microrregiões do estado de Santa Catarina através da análise envoltória de dados (DEA). Esta pesquisa caracteriza-se como descritiva e com abordagem quantitativa. A amostra deste estudo é composta pelas 20 microrregiões de Santa Catarina. Os resultados desta pesquisa indicam que 65% das microrregiões pertencentes à amostra são eficientes. A média de eficiência do estado de Santa Catarina é de 97,04%. 75% das microrregiões apresentam eficiência superior à média do estado e a microrregião menos eficiente apresentou escore de eficiência igual a 0,786, ou 78,6%. Conclui-se que o SUS é eficiente quanto ao atendimento no estado de Santa Catarina. Palavras-chave: Eficiência pública. Hospitais. Desempenho. ABSTRACTThe purpose of this study is to evaluate the question of efficiency of care SUS the twenty microregions of Santa Catarina through data envelopment analysis (DEA). This research is characterized as descriptive and quantitative approach. The sample consists of the 20 microregions of Santa Catarina. The results of this survey indicate that 65% of microregions belonging to the sample are efficient. The average efficiency of the state of Santa Catarina is 97.04%. 75% of the microregions exhibit superior efficiency to the state average and less efficient microregion efficiency scores were equal to 0.786, or 78.6%. We conclude that the SUS is efficient as the service in the state of Santa Catarina. Keywords: Public efficiency. Hospitals. Performance. RESUMENEl objetivo de este estudio es evaluar el tema de la eficiencia del tratamiento de veinte microrregiones de Santa Catarina a través de análisis envolvente de datos (DEA). Esta investigación se caracteriza como un enfoque descriptivo y cuantitativo. La muestra se compone de los 20 micro-regiones de Santa Catarina. Los resultados de este estudio indican que el 65% de las micro perteneciente a la muestra son eficientes. La eficiencia promedio del estado de Santa Catarina es de 97.04%. 75% de la micro característica de la eficiencia superior a la media del estado y menos eficiente micro presentado la eficiencia puntuación igual a 0,786, o 78,6%. Se concluye que el es eficiente ya que el servicio en el estado de Santa Catarina. Palabras clave: Eficiencia públicas. Hospitales. Rendimiento.

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“…To do this we use the estimated impact of changes in concentration on hospital prices from Keeler, Melnick and Zwanziger (KMZ) (Keeler et al, 1999).…”

mentioning

confidence: 99%

Regionalization versus competition in complex cancer surgery

Town

Heslin

2007

HEPL

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The empirical association between high hospital procedure volume and lower mortality rates has led to recommendations for the regionalization of complex surgical procedures. While regionalization may improve outcomes, it also reduces market competition, which has been found to lower prices and improve health care quality. This study estimates the potential net benefits of regionalizing the Whipple surgery for pancreatic cancer patients. We confirm that increased hospital volume and surgeon volume are associated with lower inpatient mortality rates. We then predict the price and outcome consequences of concentrating Whipple surgery at hospitals that perform at least two, four, and six procedures respectively per year. Our consumer surplus calculations suggest that regionalization can increase consumer surplus, but potential price increases extract over half of the value of reduced deaths from regionalization. We reach three conclusions. First, regionalization can increase consumer surplus, but the benefits may be substantially less than implied by examining only the outcome side of the equation. Second, modest changes in outcomes due to regionalization may lead to decreases in consumer surplus. Third, before any regionalization policy is implemented, a deep and precise understanding of the nature of both outcome/volume and price/competition relationships is needed. Regionalization Versus Competition in Complex Cancer Surgery 3 ABSTRACTThe empirical association between high hospital procedure volume and lower mortality rates has led to recommendations for the regionalization of complex surgical procedures. While regionalization may improve outcomes, it also reduces market competition, which has been found to lower prices and improve health care quality. This study estimates the potential net benefits of regionalizing the Whipple surgery for pancreatic cancer patients. We confirm that increased hospital volume and surgeon volume are associated with lower inpatient mortality rates. We then predict the price and outcome consequences of concentrating Whipple surgery at hospitals that perform at least 2, 4 and 6 procedures respectively per year. Our consumer surplus calculations suggest that regionalization can increase consumer surplus, but potential price increases extract over half of the value of reduced deaths from regionalization. We reach three conclusions. First, regionalization can increase consumer surplus, but the benefits may be substantially less than implied by examining only the outcome side of the equation. Second, modest changes in outcomes due to regionalization may lead to decreases in consumer surplus. Third, before any regionalization policy is implemented, a deep and precise understanding of the nature of both outcome/volume and price/competition relationships is needed.

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The changing effects of competition on non-profit and for-profit hospital pricing behavior

Cited by 206 publications

References 20 publications

Can Competition Save Your Life?

Can Competition Save Your Life?

Eficiência Do Atendimento Do Sus Nas Microrregiões Do Estado De Santa Catarina

Regionalization versus competition in complex cancer surgery

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