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Quarterly Journal of Economics Vol. 115 No. 2 2000

Is Hospital Competition Socially Wasteful?

Daniel P. Kessler1; M. B. McClellan2

1 Stanford University · 2 Internal Medicine

Abstract

We study the consequences of hospital competition for Medicare beneficiaries' heart attack care from 1985 to 1994. We examine how relatively exogenous determinants of hospital choice such as travel distances influence the competitiveness of hospital markets, and how hospital competition interacts with the influence of managed-care organizations to affect the key determinants of social welfare—expenditures on treatment and patient health outcomes. In the 1980s the welfare effects of competition were ambiguous; but in the 1990s competition unambiguously improves social welfare. Increasing HMO enrollment over the sample period partially explains the dramatic change in the impact of hospital competition.

DOI
10.1162/003355300554863
Volume
115
Issue
2
Pages
577-615
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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