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Expense Preference Behavior and Contract‐Management: Evidence from U.S. Hospitals

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  • Avi Dor
  • Sarah Duffy
  • Herbert Wong

Abstract

This paper reports on a study of expense preference behavior in a conditional sample of hospitals (before and after adoption of contract‐management arrangements) using an extension of Mester's (1989) test. To identify expense preference parameters, input demand equations are considered in addition to the cost function and are estimated jointly with the cost function as a system of nonlinear equations. Based on this test, contract managers do not appear to be cost minimizers, although they tend to exhibit lower expense preference behavior than salaried managers. The importance of our results, however, goes beyond a single industry because we have shown that estimates of expense preference depend critically upon the particular input demand being studied. Studies that hitherto have relied on single input demand equations or on the cost function alone may have to be reinterpreted in this light.

Suggested Citation

  • Avi Dor & Sarah Duffy & Herbert Wong, 1997. "Expense Preference Behavior and Contract‐Management: Evidence from U.S. Hospitals," Southern Economic Journal, John Wiley & Sons, vol. 64(2), pages 542-554, October.
  • Handle: RePEc:wly:soecon:v:64:y:1997:i:2:p:542-554
    DOI: 10.1002/j.2325-8012.1997.tb00072.x
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    References listed on IDEAS

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    1. Dor, Avi, 1989. "The costs of Medicare patients in nursing homes in the United States : A multiple output analysis," Journal of Health Economics, Elsevier, vol. 8(3), pages 253-270, December.
    2. Loretta J. Mester, 1989. "Testing for Expense Preference Behavior: Mutual versus Stock Savings and Loans," RAND Journal of Economics, The RAND Corporation, vol. 20(4), pages 483-498, Winter.
    3. Fournier, Gary M & Mitchell, Jean M, 1992. "Hospital Costs and Competition for Services: A Multiproduct Analysis," The Review of Economics and Statistics, MIT Press, vol. 74(4), pages 627-634, November.
    4. Dranove, David & Cone, Kenneth, 1985. "Do state rate setting regulations really lower hospital expenses?," Journal of Health Economics, Elsevier, vol. 4(2), pages 159-165, June.
    5. Edwards, Franklin R, 1977. "Managerial Objectives in Regulated Industries: Expense-Preference Behavior in Banking," Journal of Political Economy, University of Chicago Press, vol. 85(1), pages 147-162, February.
    6. Blair, Dudley W. & Placone, Dennis L., 1988. "Expense-preference behavior, agency costs, and firm organization the savings and loan industry," Journal of Economics and Business, Elsevier, vol. 40(1), pages 1-15, February.
    7. Timothy H. Hannan & Ferdinand Mavinga, 1980. "Expense Preference and Managerial Control: the Case of the Banking Firm," Bell Journal of Economics, The RAND Corporation, vol. 11(2), pages 671-682, Autumn.
    8. Dor, Avi & Farley, Dean E., 1996. "Payment source and the cost of hospital care: Evidence from a multiproduct cost function with multiple payers," Journal of Health Economics, Elsevier, vol. 15(1), pages 1-21, February.
    9. Gaynor, Martin & Anderson, Gerard F., 1995. "Uncertain demand, the structure of hospital costs, and the cost of empty hospital beds," Journal of Health Economics, Elsevier, vol. 14(3), pages 291-317, August.
    10. Zuckerman, Stephen & Hadley, Jack & Iezzoni, Lisa, 1994. "Measuring hospital efficiency with frontier cost functions," Journal of Health Economics, Elsevier, vol. 13(3), pages 255-280, October.
    11. Vita, Michael G., 1990. "Exploring hospital production relationships with flexible functional forms," Journal of Health Economics, Elsevier, vol. 9(1), pages 1-21, June.
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