HORIZONTAL HOSPITAL MERGERS

医院横向合并

• 批准号: 2237470
• 负责人: ROBERT A. CONNOR
• 金额: $ 1.76万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-09-30 至 1996-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2237470
• 关键词: HORIZONTAL; HOSPITAL; MERGERS

DESCRIPTION: This new application proposes to analyze the financial performance, operating characteristics and market area conditions of approximately 4,000 U.S. short-term general hospitals from l985-l993, to answer questions about the effects of hospital mergers. The proposed work will build on previous work by this team of investigators, extending their previous work to include additional years of data and to address additional issues. The previous study used a panel of American Hospital Association (AHA) data from 1985 to 1991 to look at hospital mergers. They found that mergers were associated with an average savings of 5%, which was shared between the hospital and consumers. The savings were greater for mergers of similar-sized hospitals and for mergers of hospitals in competitive markets. In near monopoly markets, there were no savings. The proposed study will use a longitudinal data set for the years 1985-1993 to examine the effects of hospital mergers on costs and consumer prices. It will extend the previous work by: 1) Extending the panel through 1993, which will increase the number of mergers observed; 2) Adding data that allow the examination of the impact of HMO penetration; 3) Examining the impact of geographic proximity of the merging hospitals; 4) Looking to see if the savings associated with mergers vary with the degree of overlap in the services offered by the merging hospitals; and 5) Conducting more in-depth analysis of the interaction of market concentration and mergers in their effects on hospital prices and costs. These objectives are formally stated in a long list of specific hypotheses. The model will be a modified Cobb-Douglas model that has been used by other investigators in this area. The investigators acknowledge most of the potential econometric problems and note how they will address them in the study. The panel data will be used to estimate fixed effects models that remove the potential bias of unobserved hospital-level effects. Different specifications of the merger variable and its interaction with the market conditions as measured by the Herfindahl-Hirschman Index (HHI) will be tested. The investigators address the problem that mergers cause by changing the sample size, and describe two possible ways of addressing the issue: combining the data for the merging hospitals for the pre-merger period, and using fitted pre-merger values for the pre-merger data.

描述：这个新应用程序旨在分析财务 业绩、经营特点及市场区域情况 从 1985 年到 1993 年，大约有 4,000 家美国短期综合医院， 回答有关医院合并影响的问题。拟议的 工作将建立在该研究小组之前的工作基础上， 扩展他们之前的工作以包括更多年份的数据和 解决其他问题。之前的研究使用了一组 美国医院协会（AHA）1985年至1991年的数据来看看 医院合并。他们发现合并与 平均节省 5%，由医院和医院共同承担 消费者。规模相似的企业合并节省的成本更大 医院以及竞争市场中医院的合并。在附近 垄断市场，没有储蓄。 拟议的研究将使用多年来的纵向数据集 1985-1993 研究医院合并对成本和成本的影响 消费者价格。它将通过以下方式扩展之前的工作： 1）扩展 小组到 1993 年为止，这将增加观察到的合并数量； 2) 添加可检查 HMO 影响的数据 渗透; 3) 检查地理邻近性的影响 合并医院； 4) 看看节省的费用是否与 合并随着所提供服务的重叠程度而变化 合并医院； 5) 进行更深入的分析 市场集中度与并购的交互作用 医院价格和费用。 这些目标被正式列在一长串具体的清单中 假设。该模型将是改进的柯布-道格拉斯模型 已被该领域的其他研究人员使用。调查人员 承认大多数潜在的计量经济学问题并注意它们如何 将在研究中解决这些问题。面板数据将用于估计 固定效应模型消除了未观察到的潜在偏差 医院层面的影响。合并变量的不同规格 及其与市场状况的相互作用（通过衡量） 赫芬达尔-赫希曼指数（HHI）将受到测试。 调查人员通过改变合并引起的问题来解决 样本大小，并描述解决该问题的两种可能方法： 合并合并前的医院的数据， 并对合并前数据使用拟合的合并前值。