title: Assessing competition in hospital care markets: the importance of accounting for quality differentiation.
abstract: Quality differentiation is especially important in the hospital industry, where the choices of Medicare patients are unaffected by prices. Unlike previous studies that use geographic market concentration to estimate hospital competitiveness, this article emphasizes the importance of quality differentiation in this spatially differentiated market. I estimate a random-coefficients discrete-choice model that predicts patient flow to different hospitals and find that demand responses to both distance and quality are substantial. The estimates suggest that patients do not substitute toward alternative hospitals in proportion to current market shares, implying that geographic market concentration is an inappropriate measure of hospital competitiveness.
authors.affiliation: Columbia University, USA. at436@columbia.edu.
authors.forename: Abigail
authors.initials: A
authors.lastname: Tay
mesh_terms: D004465:Economic Competition / Q000706:statistics & numerical data; D004469:Economics, Hospital / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006801:Humans; D008389:Marketing of Health Services / Q000706:statistics & numerical data; D006278:Medicare; D017059:Models, Econometric; D011785:Quality Assurance, Health Care; D014481:United States