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Efficiency, Growth, and Concentration: An Empirical Analysis of Hospital Markets

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  • Frech, H E, III
  • Mobley, Lee Rivers

Abstract

Taking an evolutionary view, Harold Demsetz hypothesized that firms differ persistently in efficiency and that industry concentration results from growth of efficient firms at the expense of inefficient ones. We test this idea with microdata from the hospital industry. Initial hospital efficiency and subsequent growth (and profitability) are significantly and positively related. Also, greater initial variation in hospital efficiency within local markets is positively related to subsequent growth in market concentration. Our findings support the evolutionary efficiency hypothesis, though they cannot confirm the stronger idea that variation in efficiency is the dominant explanation for changes in concentration. Copyright 2000 by Oxford University Press.

Suggested Citation

  • Frech, H E, III & Mobley, Lee Rivers, 2000. "Efficiency, Growth, and Concentration: An Empirical Analysis of Hospital Markets," Economic Inquiry, Western Economic Association International, vol. 38(3), pages 369-384, July.
    • Handle: RePEc:oup:ecinqu:v:38:y:2000:i:3:p:369-84
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    Cited by:

    1. C. O’Donnell & K. Nguyen, 2013. "An econometric approach to estimating support prices and measures of productivity change in public hospitals," Journal of Productivity Analysis, Springer, vol. 40(3), pages 323-335, December.
    2. Shaik, Saleem & Allen, Albert J. & Edwards, Seanicaa & Harris, James, 2009. "Market Structure Conduct Performance Hypothesis Revisited Using Stochastic Frontier Efficiency Analysis," Journal of the Transportation Research Forum, Transportation Research Forum, vol. 48(3).
    3. Roberto Colombi & Gianmaria Martini & Giorgio Vittadini, 2017. "Determinants of transient and persistent hospital efficiency: The case of Italy," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 5-22, September.
    4. Natalia Zhivan & Mark Diana, 2012. "U.S. hospital efficiency and adoption of health information technology," Health Care Management Science, Springer, vol. 15(1), pages 37-47, March.
    5. Sari, Nazmi, 2003. "Efficiency outcomes of market concentration and managed care," International Journal of Industrial Organization, Elsevier, vol. 21(10), pages 1571-1589, December.
    6. Lindrooth, Richard C. & Lo Sasso, Anthony T. & Bazzoli, Gloria J., 2003. "The effect of urban hospital closure on markets," Journal of Health Economics, Elsevier, vol. 22(5), pages 691-712, September.
    7. Edwards, Seanicaa & Allen, Albert J. & Shaik, Saleem, 2006. "Market Structure Conduct Performance (SCP) Hypothesis Revisited using Stochastic Frontier Efficiency Analysis," 2006 Annual meeting, July 23-26, Long Beach, CA 21350, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
    8. Outreville, 2015. "The market structure-performance relationship applied to the Canadian wine industry," Applied Economics Letters, Taylor & Francis Journals, vol. 22(18), pages 1486-1492, December.
    9. Chiao‐Lee Chu & Tung‐liang Chiang & Ray‐E Chang, 2011. "Hospital competition and inpatient services efficiency in Taiwan: a longitudinal study," Health Economics, John Wiley & Sons, Ltd., vol. 20(10), pages 1268-1280, October.
    10. Mobley, Lee R., 2003. "Estimating hospital market pricing: an equilibrium approach using spatial econometrics," Regional Science and Urban Economics, Elsevier, vol. 33(4), pages 489-516, July.
    11. Kim-Huong Nguyen & Tim Coelli, 2009. "Quantifying the effects of modelling choices on hospital efficiency measures: A meta-regression analysis," CEPA Working Papers Series WP072009, School of Economics, University of Queensland, Australia.

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