Zwanziger Jack, Mooney Cathleen
Health Policy and Administration (MC 923), School of Public Health, University of Illinois at Chicago, 1603 W. Taylor St., Chicago, IL 60612-4394, USA.
Inquiry. 2005 Summer;42(2):183-92. doi: 10.5034/inquiryjrnl_42.2.183.
This study analyzes the factors that influenced hospital expenses and revenues prior to and following the enactment of the New York State Health Care Reform Act of 1996 (HCRA)-the period from 1994-1999. HCRA was expected to encourage price competition which in turn was anticipated to lower hospital revenues and expenses. We measured the differential effects on hospital revenues and expenses in markets with varying degrees of competition. We also measured the relationship between hospital revenues and expenses and the increased concentration resulting from the formation of local hospital systems. We found that revenues and expenses both grew more slowly for hospitals located in more competitive markets; hospital systems that increased concentration tended to have higher revenues. In the short run at least, price competition induced by HCRA did constrain both hospital expense and revenue growth, although the increase in hospital mergers countered this trend.
本研究分析了1994年至1999年期间，即1996年纽约州医疗保健改革法案（HCRA）颁布之前及之后影响医院收支的因素。HCRA旨在鼓励价格竞争，进而预计会降低医院的收入和支出。我们衡量了不同竞争程度市场中对医院收入和支出的差异影响。我们还衡量了医院收入和支出与因地方医院系统形成导致的集中度提高之间的关系。我们发现，位于竞争更激烈市场的医院，其收入和支出增长都更缓慢；集中度提高的医院系统往往有更高的收入。至少在短期内，HCRA引发的价格竞争确实抑制了医院支出和收入的增长，尽管医院合并的增加抵消了这一趋势。
