Hospital Competition, Nursing Wages, and the Cost of Care. Executive Summary

摘要

The project used 1982 hospital and market data from a variety of statistical sources to analyze the influence of competitive forces on hospital wages, employment, occupational mix, and overall costs. Market structure was measured via the Herfindahl index of market shares for all hospitals within a 15-mile radius (700 square miles). Hospitals in the most competitive local markets were found to pay nurse wages 11 percent higher than hospitals in the least competitive markets, controlling for area cost of hiring, local nurse labor supply, and hospital characteristics such as teaching role, patient mix, and clinical facilities. Employment of nurses and non-nurse staff was 8 percent and 15 percent, respectively, higher in competitive than in non-competitive markets, while average costs per admission and per patient day, respectively, were 26 percent and 15 percent higher in competitive markets.