title: Specialty hospital market proliferation: Strategic implications for general hospitals.
abstract: BACKGROUND
  Since the early 1990s, specialty hospitals have been continuously increasing in number. A moratorium was passed in 2003 that prohibited physicians' referrals of Medicare patients to newly established specialty hospitals if the physician has ownership stakes in the hospital. Although this moratorium expired in effect in 2007, many are still demanding that the government pass new policies to discourage the proliferation of specialty hospitals.
  
  
  OBJECTIVE
  This study aimed at examining the regulatory and environmental forces that influence specialty hospitals founding rate. Specifically, we use the resource partitioning theory to investigate the relationship between general hospitals closure rates and the market entry of specialty hospitals. This study will help managers of general hospitals in their strategic thinking and planning.
  
  
  METHODS
  We rely on secondary data resources, which include the American Hospital Association, Area Resource file, census, and Center for Medicare and Medicaid Services data, to perform a longitudinal analysis of the founding rate of specialty hospital in the 48 states. Specifically, we use the negative binomial generalized estimating equation approach available through Stata 9.0 to study the effect of general hospitals closure rate and environmental variables on the proliferation of specialty hospitals.
  
  
  RESULTS
  Specialty hospitals founding rate seems to be significantly related to general hospitals closure rates. Moreover, results indicate that economic, supply, regulatory, and financial conditions determine the founding rate of specialty hospitals in different states.
  
  
  CONCLUSIONS
  The results from this study indicate that the closure of general hospitals creates market conditions that encourage the market entry of specialized health care delivery forms such as specialty hospitals. Managers of surviving general hospitals have to view the closure of other general hospitals not just as an opportunity to increase market share but also as a threat of competition from new forms of health care organizations.
authors.affiliation: Department of Health Service Research, Management, and Policy, University of Florida, USA. malamin@phhp.ufl.edu
authors.forename: Mona
authors.initials: M
authors.lastname: Al-Amin
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Zinn
authors.forename: Michael D
authors.initials: MD
authors.lastname: Rosko
authors.forename: William
authors.initials: W
authors.lastname: Aaronson
mesh_terms: D000573:American Hospital Association; D016010:Binomial Distribution; D014487:Centers for Medicare and Medicaid Services, U.S.; D003132:Commerce / Q000592:standards / Q000639:trends*; D004465:Economic Competition; D033161:Government Regulation; D006271:Health Facility Closure / Q000706:statistics & numerical data / Q000639:trends; D006284:Health Plan Implementation / Q000592:standards*; D006769:Hospitals, General / Q000706:statistics & numerical data / Q000639:trends; D006782:Hospitals, Special / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D008137:Longitudinal Studies; D014481:United States