Santerre Rexford E, Vernon John A
Center for Healthcare & Insurance Studies and Department of Finance, University of Connecticut, School of Business, CT 06269-1041, USA.
Health Econ. 2006 Nov;15(11):1187-99. doi: 10.1002/hec.1127.
This paper offers an empirical test concerning how hospital ownership mix affects consumer welfare in the US. The test compares the market benefits and costs resulting from an increased presence of nonprofit hospitals by observing empirically how the nonprofit market share impacts hospital care utilization at the margin. The empirical results suggest that too many not-for-profit and public hospitals exist in the inpatient care segment of the typical hospital services industry of the US. In contrast, the empirical findings indicate that too many for-profit hospitals operate in the outpatient care portion of the hospital services industry. The policy implication is that more quality of care per dollar might be obtained by promoting increased for-profit activity to inpatient care and more nonprofit activity to outpatient care in some market areas. This conclusion, however, is tempered with several caveats. We discuss these and also make recommendations for further research.
本文提供了一项关于医院所有制结构如何影响美国消费者福利的实证检验。该检验通过实证观察非营利性医院市场份额如何在边际上影响医院医疗服务利用情况,来比较非营利性医院增加所带来的市场收益和成本。实证结果表明,在美国典型医院服务行业的住院护理领域,存在过多的非营利性医院和公立医院。相比之下,实证结果表明,在医院服务行业的门诊护理部分,营利性医院运营过多。政策含义是,在某些市场领域,通过促进营利性活动更多地进入住院护理领域,以及非营利性活动更多地进入门诊护理领域,可能会获得更高的单位美元护理质量。然而,这一结论有几个需要注意的地方。我们将讨论这些问题,并为进一步的研究提出建议。