title: Medicare and commercial inpatient resource use: impact of hospital competition.
abstract: OBJECTIVE
  To examine the influence of hospital competition on small-area inpatient resource use by payer.
  
  
  METHODS
  We measured hospital competition and inpatient resource use using data from the 2008 Healthcare Cost and Utilization Project State Inpatient Databases. Generalized linear models adjusted for patient, population, and market characteristics were used to assess the relationship between inpatient resource use and hospital competition.
  
  
  RESULTS
  Hospital competition had a similar influence on inpatient resource intensity for Medicare and privately insured patients. Hospitals in more competitive markets had significantly lower costs per discharge for both Medicare and privately insured patients. Hospital competition was not significantly associated with length of stay per discharge for either payer.
  
  
  CONCLUSIONS
  Findings suggest that policies or incentives that promote or encourage competition in less competitive markets may reduce variation in resource use for both Medicare and private payers.
authors.affiliation: Truven Health Analytics, 150 CambridgePark Dr, Cambridge, MA 02140, USA. rachel.henke@truvenhealth.com
authors.forename: Rachel Mosher
authors.initials: RM
authors.lastname: Henke
authors.forename: Jared Lane
authors.initials: JL
authors.lastname: Maeda
authors.forename: William D
authors.initials: WD
authors.lastname: Marder
authors.forename: Barry S
authors.initials: BS
authors.lastname: Friedman
authors.forename: Herbert S
authors.initials: HS
authors.lastname: Wong
mesh_terms: D000328:Adult; D000368:Aged; D016208:Databases, Factual; D004465:Economic Competition; D004469:Economics, Hospital; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000191:economics; D016014:Linear Models; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D017062:Small-Area Analysis; D014481:United States