Journal article
Competition and Hospital Costs
JAMA : the journal of the American Medical Association, Vol.262(5), pp.616-617
08/04/1989
DOI: 10.1001/jama.1989.03430050026017
PMID: 2664234
Abstract
To the Editor.—Drs Melnick and Zwanziger1 report lower costs and costs per discharge since 1983 for California hospitals in "high-competition markets" because of legislation that promotes price-based selective contracting. We suggest that their results be interpreted cautiously.Increasing enrollment in health maintenance organizations (HMOs) (or competition from ambulatory-care providers) unrelated to bidding among hospitals can foster strategies that maintain net revenue by restraining costs. Hospitals also can respond to declines in demand by well-insured patients through greater selectivity of services and patients.Discharges declined more rapidly in the high-competition hospitals both before and after 1983,1(p2674) possibly an effect of expanding enrollment in HMOs. According to Friedman and Shortell,2 the HMO market share was inversely associated with cost in 1985.The hospitals in the high-competition subsample of Drs Melnick and Zwanziger may have tended not to bid successfully for Medicaid patients, resulting in a less expensive, more
Details
- Title: Subtitle
- Competition and Hospital Costs
- Creators
- Bernard FriedmanRichard J Bogue
- Resource Type
- Journal article
- Publication Details
- JAMA : the journal of the American Medical Association, Vol.262(5), pp.616-617
- DOI
- 10.1001/jama.1989.03430050026017
- PMID
- 2664234
- NLM abbreviation
- JAMA
- ISSN
- 0098-7484
- eISSN
- 1538-3598
- Publisher
- American Medical Association
- Language
- English
- Date published
- 08/04/1989
- Academic Unit
- Nursing
- Record Identifier
- 9984063102102771
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