Estimating the Utilization Impacts of Hospital Closures through Hospital Choice Models: A Comparison of Disaggregate and Aggregate Models

摘要

The report presents an empirical application of disaggregate and aggregate hospital choice models to a rural hospital market area. The estimated parameters from these models were used to simulate the potential impact of several possible rural hospital closures on the use of market area hospitals by Medicare beneficiaries. The estimation of two models on the same data base and time period provided quite different results whether measured by the predictions of odds ratios for the overall market or simulating changes for specific hospital closures. The report concludes that models based upon aggregate data should be used with caution.