Department of Economics, Rutgers University, New Brunswick, New Jersey.
Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, University Park, Pennsylvania.
Health Econ. 2019 Apr;28(4):492-516. doi: 10.1002/hec.3859. Epub 2019 Jan 28.
Economic theory suggests that competition and information are complementary tools for promoting health care quality. The existing empirical literature has documented this effect only in the context of competition among existing firms. Extending this literature, we examine competition driven by the entry of new firms into the home health care industry. In particular, we use the certificate of need (CON) law as a proxy for the entry of firms to avoid potential endogeneity of entry. We find that home health agencies in non-CON states improved quality under public reporting significantly more than agencies in CON states. Because home health care is a labor-intensive and capital-light industry, the state CON law is a major barrier for new firms to enter. Our findings suggest that policymakers may jointly consider information disclosure and entry regulation to achieve better quality in home health care.
经济理论表明，竞争和信息是促进医疗质量的互补工具。现有实证文献仅在现有企业竞争的背景下记录了这一效应。在扩展这一文献的过程中，我们考察了新企业进入家庭保健行业所带来的竞争。具体来说，我们使用需求证明（CON）法作为企业进入的代理，以避免进入的潜在内生性。我们发现，在公共报告制度下，非 CON 州的家庭保健机构在提高质量方面的表现明显优于 CON 州的机构。由于家庭保健是一个劳动密集型和资本轻量级的行业，州 CON 法是新企业进入的主要障碍。我们的研究结果表明，政策制定者可能会共同考虑信息披露和进入监管，以实现家庭保健服务质量的提高。
