Luft H S, Robinson J C, Garnick D W, Maerki S C, McPhee S J
Inquiry. 1986 Spring;23(1):83-94.
Because duplication of services among hospitals can be costly, it is important to understand the circumstances under which duplication occurs among hospitals within a region. In this sample of 3,584 community hospitals surveyed in 1972, we analyzed the impact of competition on the availability of specialized clinical services, with special focus on mammography, emergency services, cobalt therapy, heart surgery, and cardiac catheterization. We found that the presence of nearby institutions and services increases the availability of most of these services in neighboring hospitals. This supports the hypothesis that competition among hospitals within an open-ended reimbursement environment takes the form of nonprice competition for community-based physicians through the acquisition of expensive clinical facilities.
由于医院之间的服务重复可能成本高昂，了解某一地区内医院出现服务重复的情况很重要。在1972年调查的这3584家社区医院样本中，我们分析了竞争对专科临床服务可及性的影响，特别关注乳房X光检查、急诊服务、钴疗法、心脏手术和心导管插入术。我们发现，附近机构和服务的存在增加了邻近医院中大多数此类服务的可及性。这支持了这样一种假设，即在开放式报销环境下，医院之间的竞争采取的形式是通过购置昂贵的临床设施，对社区医生进行非价格竞争。
