IDEAS home Printed from https://ideas.repec.org/p/sip/dpaper/15-001.html
   My bibliography  Save this paper

Heterogeneous effect of residency matching and prospective payment on labor returns and hospital scale economies

Author

Listed:
  • Galina Besstremyannaya

    (Stanford University)

Abstract

The paper evaluates heterogeneous effect of participation in a residency matching program and changeover from fee-for-service to a prospective payment system on labor returns and economies of scale at acute-care public hospitals in Japan. A range of frontier technologies for multi-product output function is introduced with panel data quantile regression models, where endogenous treatment variables account for the fact that participation in both the residency matching program and the prospective payment reform was voluntary. The analysis exploits nationwide longitudinal databases on Japanese hospital participation in each of the reforms and on financial performance of regional and municipal hospitals in 2006-2012. The results demonstrate a labor-capital trade-off and lower labor intensity in the most productive hospitals. The residency matching program is positively associated with hospital production and labor productivity, especially in medium quantiles. Prospective payment has a negative effect on labor productivity, but it is only significant for hospitals in the highest quantiles.

Suggested Citation

  • Galina Besstremyannaya, 2015. "Heterogeneous effect of residency matching and prospective payment on labor returns and hospital scale economies," Discussion Papers 15-001, Stanford Institute for Economic Policy Research.
    • Handle: RePEc:sip:dpaper:15-001
    as

    Download full text from publisher

    File URL: http://www-siepr.stanford.edu/repec/sip/15-001.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Kondo, Akiko & Kawabuchi, Koichi, 2012. "Evaluation of the introduction of a diagnosis procedure combination system for patient outcome and hospitalisation charges for patients with hip fracture or lung cancer in Japan," Health Policy, Elsevier, vol. 107(2), pages 184-193.
    2. Behr, Andreas, 2010. "Quantile regression for robust bank efficiency score estimation," European Journal of Operational Research, Elsevier, vol. 200(2), pages 568-581, January.
    3. Gary S. Becker & Kevin M. Murphy, 1994. "The Division of Labor, Coordination Costs, and Knowledge," NBER Chapters, in: Human Capital: A Theoretical and Empirical Analysis with Special Reference to Education, Third Edition, pages 299-322, National Bureau of Economic Research, Inc.
    4. Dranove, David, 1998. "Economies of scale in non-revenue producing cost centers: Implications for hospital mergers," Journal of Health Economics, Elsevier, vol. 17(1), pages 69-83, January.
    5. Mark Pauly, 1980. "Appendix to "Doctors and Their Workshops: Economic Models of Physician Behavior"," NBER Chapters, in: Doctors and Their Workshops: Economic Models of Physician Behavior, pages 119-122, National Bureau of Economic Research, Inc.
    6. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    7. Galvao Jr., Antonio F., 2011. "Quantile regression for dynamic panel data with fixed effects," Journal of Econometrics, Elsevier, vol. 164(1), pages 142-157, September.
    8. Chunping Liu & Audrey Laporte & Brian S. Ferguson, 2008. "The quantile regression approach to efficiency measurement: insights from Monte Carlo simulations," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1073-1087, September.
    9. Harding, Matthew & Lamarche, Carlos, 2009. "A quantile regression approach for estimating panel data models using instrumental variables," Economics Letters, Elsevier, vol. 104(3), pages 133-135, September.
    10. Schreiber Sven, 2008. "The Hausman Test Statistic can be Negative even Asymptotically," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 228(4), pages 394-405, August.
    11. Fried, Harold O. & Lovell, C. A. Knox & Schmidt, Shelton S. (ed.), 2008. "The Measurement of Productive Efficiency and Productivity Growth," OUP Catalogue, Oxford University Press, number 9780195183528.
    12. Hausman, Jerry, 2015. "Specification tests in econometrics," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 38(2), pages 112-134.
    13. Ivan A. Canay, 2011. "A simple approach to quantile regression for panel data," Econometrics Journal, Royal Economic Society, vol. 14(3), pages 368-386, October.
    14. Koenker, Roger, 2004. "Quantile regression for longitudinal data," Journal of Multivariate Analysis, Elsevier, vol. 91(1), pages 74-89, October.
    15. Hadley, Jack & Zuckerman, Stephen, 1994. "The role of efficiency measurement in hospital rate setting," Journal of Health Economics, Elsevier, vol. 13(3), pages 335-340, October.
    16. Mark Pauly, 1980. "Doctors and Their Workshops: Economic Models of Physician Behavior," NBER Books, National Bureau of Economic Research, Inc, number paul80-1.
    17. Jesse Levin, 2001. "For whom the reductions count: A quantile regression analysis of class size and peer effects on scholastic achievement," Empirical Economics, Springer, vol. 26(1), pages 221-246.
    18. Banker, Rajiv D., 1984. "Estimating most productive scale size using data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 17(1), pages 35-44, July.
    19. Tim Coelli & Sergio Perelman, 2000. "Technical efficiency of European railways: a distance function approach," Applied Economics, Taylor & Francis Journals, vol. 32(15), pages 1967-1976.
    20. Galina Besstremyannaya, 2013. "The impact of Japanese hospital financing reform on hospital efficiency: A difference-in-difference approach," The Japanese Economic Review, Japanese Economic Association, vol. 64(3), pages 337-362, September.
    21. Kris Knox & Eric Blankmeyer & J. Stutzman, 2007. "Technical efficiency in texas nursing facilities: A stochastic production frontier approach," Journal of Economics and Finance, Springer;Academy of Economics and Finance, vol. 31(1), pages 75-86, March.
    22. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    23. Koutsomanoli-Filippaki, Anastasia I. & Mamatzakis, Emmanuel C., 2011. "Efficiency under quantile regression: What is the relationship with risk in the EU banking industry?," Review of Financial Economics, Elsevier, vol. 20(2), pages 84-95, May.
    24. Braeutigam, Ronald R. & Daughety, Andrew F., 1983. "On the estimation of returns to scale using variable cost functions," Economics Letters, Elsevier, vol. 11(1-2), pages 25-31.
    25. Miika Linna, 1998. "Measuring hospital cost efficiency with panel data models," Health Economics, John Wiley & Sons, Ltd., vol. 7(5), pages 415-427, August.
    26. Baumgardner, James R, 1988. "Physicians' Services and the Division of Labor across Local Markets," Journal of Political Economy, University of Chicago Press, vol. 96(5), pages 948-982, October.
    27. Cristina Bernini & Marzia Freo & Attilio Gardini, 2004. "Quantile estimation of frontier production function," Empirical Economics, Springer, vol. 29(2), pages 373-381, May.
    28. Sophia Dimelis & Helen Louri, 2002. "Foreign ownership and production efficiency: a quantile regression analysis," Oxford Economic Papers, Oxford University Press, vol. 54(3), pages 449-469, July.
    29. Nawata, Kazumitsu & Nitta, Ayako & Watanabe, Sonoko & Kawabuchi, Koichi, 2006. "An analysis of the length of stay and effectiveness of treatment for hip fracture patients in Japan: Evaluation of the 2002 revision of the medical service fee schedule," Journal of Health Economics, Elsevier, vol. 25(4), pages 722-739, July.
    30. Abe, Yukiko, 2007. "The effectiveness of financial incentives in controlling the health care expenditures of seniors," Japan and the World Economy, Elsevier, vol. 19(4), pages 461-482, December.
    31. John C. Panzar & Robert D. Willig, 1977. "Economies of Scale in Multi-Output Production," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 91(3), pages 481-493.
    32. Acemoglu, Daron & Autor, David, 2011. "Skills, Tasks and Technologies: Implications for Employment and Earnings," Handbook of Labor Economics, in: O. Ashenfelter & D. Card (ed.), Handbook of Labor Economics, edition 1, volume 4, chapter 12, pages 1043-1171, Elsevier.
    33. Mamatzakis, E & Koutsomanoli-Filippaki, Anastasia & Pasiouras, Fotios, 2012. "A quantile regression approach to bank efficiency measurement," MPRA Paper 51879, University Library of Munich, Germany.
    34. Naoki Ikegami, 2014. "Universal Health Coverage for Inclusive and Sustainable Development : Lessons from Japan," World Bank Publications - Books, The World Bank Group, number 20412.
    35. Sisira Sarma & Rose Anne Devlin & William Hogg, 2010. "Physician's production of primary care in Ontario, Canada," Health Economics, John Wiley & Sons, Ltd., vol. 19(1), pages 14-30, January.
    36. Jean-Jacques Laffont & Jean Tirole, 1993. "A Theory of Incentives in Procurement and Regulation," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262121743, April.
    37. Koenker, Roger W & Bassett, Gilbert, Jr, 1978. "Regression Quantiles," Econometrica, Econometric Society, vol. 46(1), pages 33-50, January.
    38. Aragon, Y. & Daouia, A. & Thomas-Agnan, C., 2005. "Nonparametric Frontier Estimation: A Conditional Quantile-Based Approach," Econometric Theory, Cambridge University Press, vol. 21(2), pages 358-389, April.
    39. Kooreman, Peter, 1994. "Nursing home care in The Netherlands: a nonparametric efficiency analysis," Journal of Health Economics, Elsevier, vol. 13(3), pages 301-316, October.
    40. Korinna K. Hansen & Jack Zwanziger, 1996. "Marginal costs in general acute care hospitals: A comparison among California, New York and Canada," Health Economics, John Wiley & Sons, Ltd., vol. 5(3), pages 195-216, May.
    41. Ricardo Gonçalves & Pedro Pita Barros, 2013. "Economies of scale and scope in the provision of diagnostic techniques and therapeutic services in Portuguese hospitals," Applied Economics, Taylor & Francis Journals, vol. 45(4), pages 415-433, February.
    42. Miraldo, Marisa & Siciliani, Luigi & Street, Andrew, 2011. "Price adjustment in the hospital sector," Journal of Health Economics, Elsevier, vol. 30(1), pages 112-125, January.
    43. Galina Besstremyannaya, 2011. "Managerial performance and cost efficiency of Japanese local public hospitals: A latent class stochastic frontier model," Health Economics, John Wiley & Sons, Ltd., vol. 20(S1), pages 19-34, September.
    44. Kim Olsen & Dorte Gyrd-Hansen & Torben Sørensen & Troels Kristensen & Peter Vedsted & Andrew Street, 2013. "Organisational determinants of production and efficiency in general practice: a population-based study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 267-276, April.
    45. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.
    46. Lynk, William J., 1995. "The creation of economic efficiencies in hospital mergers," Journal of Health Economics, Elsevier, vol. 14(5), pages 507-530, December.
    47. Caves, Douglas W & Christensen, Laurits R & Swanson, Joseph A, 1981. "Productivity Growth, Scale Economies, and Capacity Utilization in U.S. Railroads, 1955-74," American Economic Review, American Economic Association, vol. 71(5), pages 994-1002, December.
    48. Roger Koenker & Kevin F. Hallock, 2001. "Quantile Regression," Journal of Economic Perspectives, American Economic Association, vol. 15(4), pages 143-156, Fall.
    49. Nawata, K. & Kawabuchi, K., 2013. "Evaluation of the DPC-based inclusive payment system in Japan for cataract operations by a new model," Mathematics and Computers in Simulation (MATCOM), Elsevier, vol. 93(C), pages 76-85.
    50. Jensen, Gail A. & Morrisey, Michael A., 1986. "Medical staff specialty mix and hospital production," Journal of Health Economics, Elsevier, vol. 5(3), pages 253-276, September.
    51. Jayanta Bhattacharya & William B. Vogt & Aki Yoshikawa & Toshitaka Nakahara, 1996. "The Utilization of Outpatient Medical Services in Japan," Journal of Human Resources, University of Wisconsin Press, vol. 31(2), pages 450-476.
    52. Gary S. Becker, 1994. "Human Capital: A Theoretical and Empirical Analysis with Special Reference to Education, Third Edition," NBER Books, National Bureau of Economic Research, Inc, number beck94-1.
    53. Baumgardner, James R, 1988. "The Division of Labor, Local Markets, and Worker Organization," Journal of Political Economy, University of Chicago Press, vol. 96(3), pages 509-527, June.
    54. Reinhardt, U, 1972. "A Product Function for Physician Services," The Review of Economics and Statistics, MIT Press, vol. 54(1), pages 55-66, February.
    55. Hirose, Masahiro & Imanaka, Yuichi & Ishizaki, Tatsuro & Evans, Edward, 2003. "How can we improve the quality of health care in Japan?: Learning from JCQHC Hospital Accreditation," Health Policy, Elsevier, vol. 66(1), pages 29-49, October.
    56. Yuichiro Kamada & Fuhito Kojima, 2010. "Efficiency in Matching Markets with Regional Caps: The Case of the Japan Residency Matching Program," Discussion Papers 10-011, Stanford Institute for Economic Policy Research.
    57. Chernozhukov, Victor & Hansen, Christian, 2008. "Instrumental variable quantile regression: A robust inference approach," Journal of Econometrics, Elsevier, vol. 142(1), pages 379-398, January.
    58. Devlin, Rose Anne & Sarma, Sisira, 2008. "Do physician remuneration schemes matter? The case of Canadian family physicians," Journal of Health Economics, Elsevier, vol. 27(5), pages 1168-1181, September.
    59. Custer, William S. & Moser, James W. & Musacchio, Robert A. & Willke, Richard J., 1990. "The production of health care services and changing hospital reimbursement : The role of hospital-medical staff relationships," Journal of Health Economics, Elsevier, vol. 9(2), pages 167-192, September.
    60. Cazals, Catherine & Florens, Jean-Pierre & Simar, Leopold, 2002. "Nonparametric frontier estimation: a robust approach," Journal of Econometrics, Elsevier, vol. 106(1), pages 1-25, January.
    61. Atsushi Fuj & Makoto Ohta, 1999. "Stochastic cost frontier and cost inefficiency of Japanese hospitals: a panel data analysis," Applied Economics Letters, Taylor & Francis Journals, vol. 6(8), pages 527-532.
    62. Aigner, Dennis & Lovell, C. A. Knox & Schmidt, Peter, 1977. "Formulation and estimation of stochastic frontier production function models," Journal of Econometrics, Elsevier, vol. 6(1), pages 21-37, July.
    63. Chernozhukov, Victor & Hansen, Christian, 2006. "Instrumental quantile regression inference for structural and treatment effect models," Journal of Econometrics, Elsevier, vol. 132(2), pages 491-525, June.
    64. Becker, Edmund R & Sloan, Frank A, 1985. "Hospital Ownership and Performance," Economic Inquiry, Western Economic Association International, vol. 23(1), pages 21-36, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Galina Besstremyannaya, 2015. "The adverse effects of incentives regulation in health care: a comparative analysis with the U.S. and Japanese hospital data," Working Papers w0218, Center for Economic and Financial Research (CEFIR).
    2. Galina Besstremyannaya, 2015. "The adverse effects of incentives regulation in health care: a comparative analysis with the U.S. and Japanese hospital data," Working Papers w0218, New Economic School (NES).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Galina Besstremyannaya, 2014. "The efficiency of labor matching and remuneration reforms: a panel data quantile regression approach with endogenous treatment variables," Working Papers w0206, New Economic School (NES).
    2. Galina Besstremyannaya, 2014. "The efficiency of labor matching and remuneration reforms: a panel data quantile regression approach with endogenous treatment variables," Working Papers w0206, Center for Economic and Financial Research (CEFIR).
    3. Galina Besstremyannaya & Sergei Golovan, 2023. "Measuring heterogeneity in hospital productivity: a quantile regression approach," Journal of Productivity Analysis, Springer, vol. 59(1), pages 15-43, February.
    4. Besstremyannaya, Galina, 2017. "Heterogeneous effect of the global financial crisis and the Great East Japan Earthquake on costs of Japanese banks," Journal of Empirical Finance, Elsevier, vol. 42(C), pages 66-89.
    5. Galina Besstremyannaya, 2014. "The adverse effects of value-based purchasing in health care: dynamic quantile regression with endogeneity," Discussion Papers 14-006, Stanford Institute for Economic Policy Research.
    6. Galina Besstremyannaya, 2015. "The adverse effects of incentives regulation in health care: a comparative analysis with the U.S. and Japanese hospital data," Working Papers w0218, Center for Economic and Financial Research (CEFIR).
    7. Galina Besstremyannaya, 2015. "The adverse effects of incentives regulation in health care: a comparative analysis with the U.S. and Japanese hospital data," Working Papers w0218, New Economic School (NES).
    8. Harding, Matthew & Lamarche, Carlos, 2014. "Estimating and testing a quantile regression model with interactive effects," Journal of Econometrics, Elsevier, vol. 178(P1), pages 101-113.
    9. Panagiotidis, Theodore & Printzis, Panagiotis, 2021. "Investment and uncertainty: Are large firms different from small ones?," Journal of Economic Behavior & Organization, Elsevier, vol. 184(C), pages 302-317.
    10. Maria Marino & Alessio Farcomeni, 2015. "Linear quantile regression models for longitudinal experiments: an overview," METRON, Springer;Sapienza Università di Roma, vol. 73(2), pages 229-247, August.
    11. David Powell & Joachim Wagner, 2021. "The Exporter Productivity Premium Along the Productivity Distribution: Evidence from Quantile Regression with Nonadditive Firm Fixed Effects," World Scientific Book Chapters, in: Joachim Wagner (ed.), MICROECONOMETRIC STUDIES OF FIRMS’ IMPORTS AND EXPORTS Advanced Methods of Analysis and Evidence from German Enterprises, chapter 9, pages 121-149, World Scientific Publishing Co. Pte. Ltd..
    12. Bernstein, David H. & Parmeter, Christopher F. & Tsionas, Mike G., 2023. "On the performance of the United States nuclear power sector: A Bayesian approach," Energy Economics, Elsevier, vol. 125(C).
    13. Andini, Corrado & Andini, Monica, 2015. "A Note on Unemployment Persistence and Quantile Parameter Heterogeneity," IZA Discussion Papers 8819, Institute of Labor Economics (IZA).
    14. Denis Chetverikov & Bradley Larsen & Christopher Palmer, 2016. "IV Quantile Regression for Group‐Level Treatments, With an Application to the Distributional Effects of Trade," Econometrica, Econometric Society, vol. 84, pages 809-833, March.
    15. Léopold Simar & Paul W. Wilson, 2015. "Statistical Approaches for Non-parametric Frontier Models: A Guided Tour," International Statistical Review, International Statistical Institute, vol. 83(1), pages 77-110, April.
    16. José Manuel Pastor & Jose M. Pavía & Lorenzo Serrano & Emili Tortosa-Ausina, 2017. "Rich regions, poor regions and bank branch deregulation in Spain," Regional Studies, Taylor & Francis Journals, vol. 51(11), pages 1678-1694, November.
    17. Minjung Kim, 2013. "Productivity Performance and Exporting Activity of Korean Manufacturing Firms: Quantile Regression Approach," Economic Analysis (Quarterly), Economic Research Institute, Bank of Korea, vol. 19(2), pages 97-120, June.
    18. Arribas, Iván & Peiró-Palomino, Jesús & Tortosa-Ausina, Emili, 2020. "Is full banking integration desirable?," Journal of Banking & Finance, Elsevier, vol. 112(C).
    19. Machado, José A.F. & Santos Silva, J.M.C., 2019. "Quantiles via moments," Journal of Econometrics, Elsevier, vol. 213(1), pages 145-173.
    20. Li Tao & Yuanjie Zhang & Maozai Tian, 2019. "Quantile Regression for Dynamic Panel Data Using Hausman–Taylor Instrumental Variables," Computational Economics, Springer;Society for Computational Economics, vol. 53(3), pages 1033-1069, March.

    More about this item

    Keywords

    quantile regressions; economies of scale; labor productivity; hospitals;
    All these keywords.

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sip:dpaper:15-001. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Anne Shor (email available below). General contact details of provider: https://edirc.repec.org/data/cestaus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.