Prospective Payment System Evaluation Studies: Hospital Market Structures and PPS

摘要

The report explores the relationship of the structure of hospital markets to hospitals' average costs and to changes in those costs in the first three years of Medicare's prospective payment system (PPS). These analyses are part of a larger evaluation of the impact of PPS on the nation's hospital industry. Chapter 1 discusses the types of market structures, outlines the elements of market structure, both in general and for hospitals, and briefly reviews the literature on hospital markets and outcomes. Chapter 2 describes the data used in the empirical work. Hospital markets are described in Chapter 3, while multivariate regression analysis of average costs, relating them to market structure, is the topic of Chapter 4. Chapter 4 also examines the relationship of structure to changes in costs and lengths of stay, and to financial measures. Finally, it shows how market structure has changed since 1983.