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The Effects of Chains on the Measurement of Competition in the Nursing Home Industry.
Hirth, Richard A; Zheng, Qing; Grabowski, David C; Stevenson, David G; Intrator, Orna; Banaszak-Holl, Jane.
Afiliación
  • Hirth RA; 1 University of Michigan, Ann Arbor, MI, USA.
  • Zheng Q; 1 University of Michigan, Ann Arbor, MI, USA.
  • Grabowski DC; 2 Harvard Medical School, Boston, MA, USA.
  • Stevenson DG; 3 Vanderbilt University, Nashville, TN, USA.
  • Intrator O; 4 University of Rochester Medical Center, Rochester, NY, USA.
  • Banaszak-Holl J; 1 University of Michigan, Ann Arbor, MI, USA.
Med Care Res Rev ; 76(3): 315-336, 2019 06.
Article en En | MEDLINE | ID: mdl-29148340
Consistently accounting for more than 50% of the nursing homes in the United States, corporate chains have played an important role in the industry for several decades. However, few studies have explicitly considered the role of chains in measuring competition in nursing home markets. In this study, we use a newly developed database tracking common ownership over a period of nearly two decades to compare chain-adjusted and unadjusted measures of competition at the county and 25 km fixed-radius levels and explore how the differences would affect the assessment of local market structure. On average, the chain-adjusted Herfindahl-Hirschman Indexes (HHIs) are about 0.02 higher than the unadjusted HHIs. Each year, about 20% to 22% of the counties would appear more concentrated when recalculating HHIs accounting for common ownership. Evidence suggests that nursing home chains tend to focus more on expanding access to new markets within a state than to increasing market power within a smaller local market.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propiedad / Competencia Económica / Casas de Salud Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Med Care Res Rev Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Propiedad / Competencia Económica / Casas de Salud Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: Med Care Res Rev Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos