Competition and waiting times in hospital markets

被引:73
作者
Brekke, Kurt R. [1 ]
Siciliani, Luigi [2 ,3 ,4 ]
Straume, Odd Rune [5 ,6 ,7 ]
机构
[1] Norwegian Sch Econ & Business Adm, Dept Econ & Hlth Econ Bergen, N-5045 Bergen, Norway
[2] Univ York, Dept Econ & Related Studies, York YO10 5DD, N Yorkshire, England
[3] Univ York, Ctr Hlth Econ, York YO10 5DD, N Yorkshire, England
[4] CEPR, London EC1V 7DB, England
[5] Univ Minho, Dept Econ, P-4710057 Braga, Portugal
[6] Univ Minho, NIPE, P-4710057 Braga, Portugal
[7] Hlth Econ Bergen, Bergen, Norway
关键词
hospitals; competition; waiting times;
D O I
10.1016/j.jpubeco.2008.02.003
中图分类号
F [经济];
学科分类号
02 ;
摘要
This paper studies the impact of hospital competition on waiting times. We use a Salop-type model, with hospitals that differ in (geographical) location and, potentially, waiting time, and two types of patients: high-benefit patients who choose between neighbouring hospitals (competitive segment), and low-benefit patients who decide whether or not to demand treatment from the closest hospital (monopoly segment). Compared with a benchmark case of monopoly, we find that hospital competition leads to longer wailing times in equilibrium if the competitive segment is sufficiently large. Given a policy regime of hospital competition, the effect of increased competition depends on the parameter of measurement: Lower travelling costs increase waiting times, higher hospital density reduces waiting times, while the effect of a larger competitive segment is ambiguous. We also show that, if the competitive segment is large, hospital competition is socially preferable to monopoly only if the (regulated) treatment price is sufficiently high. (c) 2008 Elsevier B.V. All rights reserved.
引用
收藏
页码:1607 / 1628
页数:22
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