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Market concentration and performance of general hospitals in Poland

Author

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  • Blazej Lyszczarz

    (Nicolaus Copernicus University)

Abstract

Theories of the hospital market view hospitals as competing for patients, physicians and third-party payers simultaneously. The competition involves such elements as price, quality, convenience, technology and innovation and the effects of the competition in the market affect the quality of care, clinical outcomes, cost of services, access as well as patient satisfaction. The purpose of the paper is to shed some light on the impact of competition on the performance of general hospitals in Poland. Due to the unavailability of micro-level data, territorial concentration based on regional data is used as a proxy for the scope of competition. Therefore, the territorial concentration of hospital beds is measured with the use of the Herfindahl-Hirschman index (HHI) for each of the 16 provinces of Poland and for the four-year period of 2008-2011. In the second stage, the values of the concentration index are correlated with a set of variables describing the performance of hospitals. The results show that the concentration of hospital beds in the regions is uneven. The regions with the most concentrated markets (zachodniopomorskie, lodzkie, podlaskie and mazowieckie) are characterized by four times higher values of the HHI than the one with the least concentrated market (slaskie). The results suggest that a higher concentration in the hospital market correlates with a larger number of patients treated and an increase in the cost of services.

Suggested Citation

  • Blazej Lyszczarz, 2014. "Market concentration and performance of general hospitals in Poland," Ekonomia i Prawo, Uniwersytet Mikolaja Kopernika, vol. 13(4), pages 499-510, December.
    • Handle: RePEc:cpn:umkeip:v:13:y:2014:i:4:p:499-510
    DOI: 10.12775/EiP.2014.035
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    References listed on IDEAS

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    1. Toni Ashton & David Press, 1997. "Market Concentration in Secondary Health Services Under a Purchaser–Provider Split: The New Zealand Experience," Health Economics, John Wiley & Sons, Ltd., vol. 6(1), pages 43-56, January.
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    More about this item

    Keywords

    competition; hospitals; Herfindahl–Hirschman Index;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • D40 - Microeconomics - - Market Structure, Pricing, and Design - - - General
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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