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Investment and quality competition in healthcare markets

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Resumo:We study the strategic relationship between hospital investment and provision of service quality. We use a spatial competition framework and allow investment and quality to be complements or substitutes in patient benefit and provider cost. We assume that each hospital commits to a certain investment before deciding on service quality, and that investment is observable and contractible while quality is observable but not contractible. We show that, under a fixed DRG-pricing system, providers’ lack of ability to commit to quality leads to under- or overinvestment, relative to the first-best solution. Underinvestment arises when the price-cost margin is positive, and quality and investments are strategic complements, which has implications for optimal contracting. Differently from the simultaneous-move case, the regulator must complement the payment with one more instrument to address under/overinvestment. We also analyse the welfare effects of different policy options (separate payment for investment, higher per-treatment prices, or DRG-refinement policies).
Autores principais:Ghandour, Ziad
Outros Autores:Siciliani, Luigi; Straume, Odd Rune
Assunto:Hospital payment Investment Quality competition
Ano:2022
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Universidade do Minho
Idioma:inglês
Origem:RepositóriUM - Universidade do Minho
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author Ghandour, Ziad
author2 Siciliani, Luigi
Straume, Odd Rune
author2_role author
author
author_facet Ghandour, Ziad
Siciliani, Luigi
Straume, Odd Rune
author_role author
contributor_name_str_mv RepositóriUM - Universidade do Minho
country_str PT
creators_json_txt [{\"Person.name\":\"Ghandour, Ziad\"},{\"Person.name\":\"Siciliani, Luigi\"},{\"Person.name\":\"Straume, Odd Rune\"}]
datacite.contributors.contributor.contributorName.fl_str_mv RepositóriUM - Universidade do Minho
datacite.creators.creator.creatorName.fl_str_mv Ghandour, Ziad
Siciliani, Luigi
Straume, Odd Rune
datacite.date.Accepted.fl_str_mv 2022-01-01T00:00:00Z
datacite.date.available.fl_str_mv 2024-01-14T07:00:29Z
datacite.date.embargoed.fl_str_mv 2024-01-14T07:00:29Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Hospital payment
Investment
Quality competition
datacite.titles.title.fl_str_mv Investment and quality competition in healthcare markets
dc.contributor.none.fl_str_mv RepositóriUM - Universidade do Minho
dc.creator.none.fl_str_mv Ghandour, Ziad
Siciliani, Luigi
Straume, Odd Rune
dc.date.Accepted.fl_str_mv 2022-01-01T00:00:00Z
dc.date.available.fl_str_mv 2024-01-14T07:00:29Z
dc.date.embargoed.fl_str_mv 2024-01-14T07:00:29Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv https://hdl.handle.net/1822/76487
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Elsevier
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv Hospital payment
Investment
Quality competition
dc.title.fl_str_mv Investment and quality competition in healthcare markets
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description We study the strategic relationship between hospital investment and provision of service quality. We use a spatial competition framework and allow investment and quality to be complements or substitutes in patient benefit and provider cost. We assume that each hospital commits to a certain investment before deciding on service quality, and that investment is observable and contractible while quality is observable but not contractible. We show that, under a fixed DRG-pricing system, providers’ lack of ability to commit to quality leads to under- or overinvestment, relative to the first-best solution. Underinvestment arises when the price-cost margin is positive, and quality and investments are strategic complements, which has implications for optimal contracting. Differently from the simultaneous-move case, the regulator must complement the payment with one more instrument to address under/overinvestment. We also analyse the welfare effects of different policy options (separate payment for investment, higher per-treatment prices, or DRG-refinement policies).
dirty 0
eu_rights_str_mv openAccess
format article
fulltext.url.fl_str_mv https://repositorium.uminho.pt/bitstreams/837782b6-f237-415a-8a24-72e2e8b1ee9a/download
id rum_bb060caef901fc603e2d7ebf2e9b765f
identifier.url.fl_str_mv https://hdl.handle.net/1822/76487
instacron_str repositorium
institution Universidade do Minho
instname_str Universidade do Minho
language eng
network_acronym_str rum
network_name_str RepositóriUM - Universidade do Minho
oai_identifier_str oai:repositorium.uminho.pt:1822/76487
organization_str_mv urn:organizationAcronym:repositorium
person_str_mv Ghandour, Ziad
Siciliani, Luigi
Straume, Odd Rune
publishDate 2022
publisher.none.fl_str_mv Elsevier
reponame_str RepositóriUM - Universidade do Minho
repository_id_str urn:repositoryAcronym:rum
service_str_mv urn:repositoryAcronym:rum
spelling engElsevierporWe study the strategic relationship between hospital investment and provision of service quality. We use a spatial competition framework and allow investment and quality to be complements or substitutes in patient benefit and provider cost. We assume that each hospital commits to a certain investment before deciding on service quality, and that investment is observable and contractible while quality is observable but not contractible. We show that, under a fixed DRG-pricing system, providers’ lack of ability to commit to quality leads to under- or overinvestment, relative to the first-best solution. Underinvestment arises when the price-cost margin is positive, and quality and investments are strategic complements, which has implications for optimal contracting. Differently from the simultaneous-move case, the regulator must complement the payment with one more instrument to address under/overinvestment. We also analyse the welfare effects of different policy options (separate payment for investment, higher per-treatment prices, or DRG-refinement policies).application/pdfporInvestment and quality competition in healthcare marketsGhandour, ZiadSiciliani, LuigiStraume, Odd RuneHostingInstitutionOrganizationalRepositóriUM - Universidade do Minhoe-mailmailto:repositorium@usdb.uminho.ptrepositorium@usdb.uminho.ptCITATIONGhandour, Z., Siciliani, L., & Straume, O. R. (2022, March). Investment and quality competition in healthcare markets. Journal of Health Economics. Elsevier BV. http://doi.org/10.1016/j.jhealeco.2022.102588PMID35065851ISSNIsPartOf0167-6296DOIIsPartOf10.1016/j.jhealeco.2022.1025882024-01-14T07:00:29Z20222022-03-11T11:38:08Z2022-01-01T00:00:00ZHandlehttps://hdl.handle.net/1822/76487http://purl.org/coar/access_right/c_abf2open accessHospital paymentInvestmentQuality competition476311 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorium.uminho.pt/bitstreams/837782b6-f237-415a-8a24-72e2e8b1ee9a/download
spellingShingle Investment and quality competition in healthcare markets
Ghandour, Ziad
Hospital payment
Investment
Quality competition
status SINGLETON
subject.fl_str_mv Hospital payment
Investment
Quality competition
title Investment and quality competition in healthcare markets
title_full Investment and quality competition in healthcare markets
title_fullStr Investment and quality competition in healthcare markets
title_full_unstemmed Investment and quality competition in healthcare markets
title_short Investment and quality competition in healthcare markets
title_sort Investment and quality competition in healthcare markets
topic Hospital payment
Investment
Quality competition
topic_facet Hospital payment
Investment
Quality competition
url https://hdl.handle.net/1822/76487
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