Exit from the Hospital Industry

Ciliberto, Federico and Lindrooth, Richard (2007): Exit from the Hospital Industry. Published in: Economic Inquiry , Vol. 45, No. 1 (1 January 2007): pp. 71-81.

Abstract

We study the exit of hospitals from the market for inpatient services. More generous hospital reimbursement significantly reduces the probability of exit throughout the 1990s. Conditional on reimbursement levels, hospital efficiency was not a significant determinant in the early 1990s but in the mid- to late 1990s, less efficient hospitals were significantly more likely to exit. Throughout the period, high-tech services increased the probability of survival, and for-profit hospitals were more likely to exit. The role of Medicare as a determinant of exit became less important in the latter half of the 1990s.

• Item Type: MPRA Paper
• Language: English
• Keywords: Hospital Industry, Managed Care, Exit, Inpatient Services, Technology.
• Subjects: I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets; L - Industrial Organization > L1 - Market Structure, Firm Strategy, and Market Performance > L11 - Production, Pricing, and Market Structure ; Size Distribution of Firms

References

Bertrand, M., E. Duflo, and S. Mullainathan. ‘‘How Much Should We Trust Difference-in-Differences Estimates?’’ Quarterly Journal of Economics, 119(1), 2004, 249–75.

Capps, C., D. Dranove, and M. Satterthwaite. ‘‘Competition and Market Power in Option Demand Markets.’’ RAND Journal of Economics, 34(4), 2003, 737–63.

Deily, M. E. ‘‘Exit Strategies and Plant-Closing Decisions: The Case of Steel.’’ RAND Journal of Economics, 22(2), 1991, 250–63.

Deily, M. E., N. L. McKay, and F. H. Dorner. ‘‘Exit and Inefficiency: The Effects of Ownership Type.’’ Journal of Human Resources, 35(4), 2000, 734–47.

Ghemawat, P., and B. Nalebuff. ‘‘Exit.’’ RAND Journal of Economics, 16(2), 1985, 184–94. ———. ‘‘The Devolution of Declining Industries.’’ Quarterly Journal of Economics, 105(1), 1990, 167–86.

Gibson, J. K., and R. I. D. Harris. ‘‘Trade Liberalisation and Plant Exit in New Zealand Manufacturing.’’ Review of Economics and Statistics, 78(3), 1996, 521–29.

Heckman, J. J. ‘‘Statistical Models for Discrete Panel Data,’’ in Structural Analysis of Discrete Data with 80 ECONOMIC INQUIRY Econometric Applications, edited C. Manski and D. McFadden. Cambridge, MA: MIT Press, 1981a.

———. ‘‘The Incidental Parameters Problem and the Problem of Initial Conditions in Estimating a Discrete Time-Discrete Data Stochastic Process,’’ in Structural Analysis of Discrete Data with Econometric Applications, edited C.Manski and D.McFadden. Cambridge, MA: MIT Press, 1981b.

Lindrooth, R. C., A. LoSasso, and G. Bazzoli. ‘‘The Effect of Exit on Hospital Markets.’’ Journal of Health Economics, 22(5), 2003, 691–712.

Skinner, J. ‘‘What Do Stochastic Frontier Cost Functions Tell Us about Inefficiency?’’ Journal of Health Economics, 13(3), 1994, 323–28.

Tay, A. ‘‘Assessing Competition in Hospital Care Markets: The Importance of Accounting for Quality Differentiation.’’ RAND Journal of Economics, 34, 2003, 786–814.

Wedig, G. J., M. Hassan, and F. A. Sloan. ‘‘Hospital Investment Decisions and the Cost of Capital.’’ Journal of Business, 62(4), 1989, 517–37.

Whinston, M. D. ‘‘Exit with Multiplant Firms.’’ RAND Journal of Economics, 19(4), 1988, 568–84.

Wholey, D. R., J. B. Christianson, J. Engberg, and C. Bryce. ‘‘HMO Market Structure and Performance: 1985–1995.’’ Health Affairs, 16(6), 1997, 75–84.

Williams, D., J. Hadley, and J. Pettengill. ‘‘Profits, Community Role, and Hospital Closure: An Urban and Rural Analysis.’’ Medical Care, 30(2), 1992, 174–87.