所有医院系统都具有市场影响力吗？医院系统类型与心脏手术价格之间的关联。
Do All Hospital Systems Have Market Power? Association Between Hospital System Types and Cardiac Surgery Prices.
作者信息
Choi Sung W, Dor Avi
机构信息
Health Administration, School of Public Affairs, The Pennsylvania State University, Harrisburg, PA, USA.
Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
出版信息
Health Serv Res Manag Epidemiol. 2019 Nov 11;6:2333392819886414. doi: 10.1177/2333392819886414. eCollection 2019 Jan-Dec.
OBJECTIVE
This study explores the price implications of hospital systems by analyzing the association of system characteristics with selected cardiac surgery pricing.
DATA SOURCE
Using a large private insurance claim database, the authors identified 11 282 coronary artery bypass graft (CABG) cases and 49 866 percutaneous coronary intervention (PCI) cases from 2002 to 2007.
STUDY DESIGN
We conducted a retrospective observational study using generalized linear models.
PRINCIPAL FINDINGS
We found that the CABG and PCI prices in centralized health and physician insurance systems were significantly lower than the prices in stand-alone hospitals by 4.4% and 6.4%, respectively. In addition, the CABG and PCI prices in independent health systems were significantly lower than in stand-alone hospitals, by 15.4% and 14.5%, respectively.
CONCLUSION
The current antitrust guidelines tend to focus on the market share of merging parties and pay less attention to the characteristics of merging parties. The results of this study suggest that antitrust analysis could be more effective by considering characteristics of hospital systems.
目的
本研究通过分析系统特征与所选心脏手术定价之间的关联，探讨医院系统的价格影响。
数据来源
作者利用一个大型私人保险理赔数据库，识别出2002年至2007年期间的11282例冠状动脉搭桥术（CABG）病例和49866例经皮冠状动脉介入治疗（PCI）病例。
研究设计
我们使用广义线性模型进行了一项回顾性观察研究。
主要发现
我们发现，集中式医疗和医生保险系统中的CABG和PCI价格分别比独立医院的价格显著低4.4%和6.4%。此外，独立医疗系统中的CABG和PCI价格分别比独立医院的价格显著低15.4%和14.5%。
结论
当前的反垄断指南倾向于关注合并方的市场份额，而较少关注合并方的特征。本研究结果表明，考虑医院系统的特征可能会使反垄断分析更有效。
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