TY - JOUR
T1 - The impact of hospital competition and insurer concentration on health care volume and cost in Dutch hospitals
AU - Krabbe-Alkemade, Yvonne
AU - Groot, Tom
AU - Boter, Jaap
PY - 2019/9/5
Y1 - 2019/9/5
N2 - This study analyses the effect of spatial concentration of general hospitals, the appearance of independent treatment centers (in Dutch: Zelfstandige Behandelcentra: ZBCs) and the concentration of health insurers on production volume and costs since the introduction of market-oriented health care reforms in the Netherlands. We use regression analyses of 1,345,144 patient-level hospital data for fifteen major diagnosis treatment combinations (in Dutch: Diagnose Behandeling Combinaties: DBCs), representing 70% of the managed competition segment (the so-called B-segment).We find that spatial concentration of hospitals and concentration of insurers do not affect health care production volume. More competitive hospital markets are associated with higher cost of most DBCs studied. Surprisingly, hospitals operating under insurers with high monopsonic power incur higher average DBC-cost than hospitals operating under insurers with more dispersed power. The number of independent treatment centers in the hospital’s vicinity is positively related to health care volume and average cost.
AB - This study analyses the effect of spatial concentration of general hospitals, the appearance of independent treatment centers (in Dutch: Zelfstandige Behandelcentra: ZBCs) and the concentration of health insurers on production volume and costs since the introduction of market-oriented health care reforms in the Netherlands. We use regression analyses of 1,345,144 patient-level hospital data for fifteen major diagnosis treatment combinations (in Dutch: Diagnose Behandeling Combinaties: DBCs), representing 70% of the managed competition segment (the so-called B-segment).We find that spatial concentration of hospitals and concentration of insurers do not affect health care production volume. More competitive hospital markets are associated with higher cost of most DBCs studied. Surprisingly, hospitals operating under insurers with high monopsonic power incur higher average DBC-cost than hospitals operating under insurers with more dispersed power. The number of independent treatment centers in the hospital’s vicinity is positively related to health care volume and average cost.
KW - Health Care Costs
KW - Health Care Reform: economics
UR - http://www.mendeley.com/research/impact-hospital-competition-insurer-concentration-health-care-volume-cost-dutch-hospitals
U2 - 10.5117/mab.93.34164
DO - 10.5117/mab.93.34164
M3 - Article
SN - 0924-6304
VL - 93
SP - 203
EP - 213
JO - Maandblad voor accountancy en bedrijfseconomie
JF - Maandblad voor accountancy en bedrijfseconomie
IS - 7/8
M1 - 34164
ER -