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Stochastic Demand for Hospitals and Optimizing "Excess" Bed Capacity

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Abstract

This paper addresses the issue of hospital bed capacity by considering the stochastic demand for United States hospitals. An equilibrium condition for the optimal number of "excess" beds is derived and applied using a cost function estimated with a panel data model for the period 1987-1992. Results indicate that it may be difficult to justify the costliness of existing levels of empty hospital beds. The Department of Justice and the Federal Trade Commission should be cognizant of the potential effects of hospital mergers on undesirable excess bed capacity.

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References

  • Allen, Robin. 1992. “Policy Implications of Recent Hospital Competition Studies.” Journal of Health Economics 11:347–351.

    Google Scholar 

  • Bazzoli, Gloria. et al. 1994. “Effects of Horizontal Consolidation on Hospital Markets: Concentration Lowers Cost/Prices.” Antitrust Law and Economics Review 25:45–62.

    Google Scholar 

  • Bazzoli, Gloria, David Marx Jr., Richard Arnould and Larry Mannheim. 1995. “Federal Antitrust Merger Enforcement Standards: A Good Fit for the Hospital Industry?” Journal of Health Politics, Policy and Law 20:137–169.

    Google Scholar 

  • Bogue, Richard, Stephen Shortell, Min-Woong Sohn, Larry Mannheim, Gloria Bazzoli, and Cheeling Chan. 1995. “Hospital Reorganization After Merger.” Medical Care 33:676–686.

    Google Scholar 

  • Carey, Kathleen. 1997. “A Panel Data Design for Estimation of Hospital Cost Functions.” The Review of Economics and Statistics LXXIX:443–453.

    Google Scholar 

  • Carey, Kathleen, and Theodore Stefos. 1992. “A cost function approach to measurement of hospital output.” Health Care Financing Review 14:115–124.

    Google Scholar 

  • Cowing, Thomas, and Alphonse Holtmann. 1983. “Multiproduct Short-Run Hospital Cost Functions: Empirical Evidence and Policy Implications from Cross-Section Data.” Southern Economic Journal 49:637–653.

    Google Scholar 

  • Department of Justice and Federal Trade Commission. 1992. “Horizontal Merger Guidelines.” [Reprinted in full text in Antitrust Law and Economics Review Vol. 23 Nos. 2 and 3.]

  • Department of Justice and Federal Trade Commission. 1993. “Policy Statements of U.S. Justice Department and Federal Trade Commission on Antitrust Enforcement in the Health Care Industry.” [See Antitrust Law and Economics Review 25:25–36.]

    Google Scholar 

  • Dranove, David, and William White. 1994. “Recent Theory and Evidence on Competition in Hospital Markets.” Journal of Economics and Management Strategy 3:169–209.

    Google Scholar 

  • Dor, Avi, and Dean Farley. 1996. “Payment Source and the Cost of Hospital Care: Evidence from a Multiproduct Cost Function with Multiple Payers.” Journal of Health Economics 15:1–21.

    Google Scholar 

  • Ellis, Randall. 1991. “Hospital Cost Function Estimation When Firms May Not Try to Minimize Total Costs.” Discussion Paper #29:Boston University.

  • Friedman, Bernard, and Mark Pauly. 1981. “Cost Function for a Service Firm with Variable Quality and Stochastic Demand: The Case of Hospitals.” The Review of Economics and Statistics LXIII:620–624.

    Google Scholar 

  • Friedman, Bernard, and Mark Pauly. 1983. “A New Approach to Hospital Cost Functions and Some Issues in Revenue Regulation.” Health Care Financing Review 4:105–114.

    Google Scholar 

  • Gal-Or, Esther. 1994. “Excessive Investment in Hospital Capacities.” Journal of Economics and Management Strategy 3:53–70.

    Google Scholar 

  • Gaynor, Martin, and Gerard Anderson. 1995. “Uncertain Demand, The Structure of Hospital Costs and the Cost of Empty Hospital Beds.” Journal of Health Economics 14:291–317.

    Google Scholar 

  • Grannemann, Thomas, Randall Brown, and Mark Pauly. 1986. “Estimating Hospital Costs: A Multiple Output Analysis.” Journal of Health Economics 5:107–127.

    Google Scholar 

  • Hadley, Jack, and Katherine Swartz. 1989. “The Impact on Hospital Costs Between 1980 and 1984 of Hospital Rate Regulation, Competition, and Changes in Health Insurance Coverage.” Inquiry 26:35–47.

    Google Scholar 

  • Hausman, Jerry. 1978. “Specification Tests in Econometrics.” Econometrica 46:115–124.

    Google Scholar 

  • Hausman, Jerry, and William Taylor. 1981. “Panel Data and Unobservable Individual Effects.” Econometrica 49:1377–1398.

    Google Scholar 

  • Joskow, Paul. 1980. “The Effects of Competition and Regulation on Hospital Bed Supply and the Reservation Quality of the Hospital.” Bell Journal of Economics 11:421–447.

    Google Scholar 

  • Keeler, Theodore, and John Ying. 1996. “Hospital Costs and Excess Bed Capacity: A Statistical Analysis.” The Review of Economics and Statistics, LXXVIII:470–481.

    Google Scholar 

  • Magleby, James. 1996. “Hospital mergers and antitrust policy: arguments against a modification of current antitrust law.” The Antitrust Bulletin 41:137–201.

    Google Scholar 

  • Management Science Group, U.S. Department of Veterans Affairs. 1993. “A Comparison of the Operating Costs and Performance of VA and Nonfederal Hospitals: 1984–1992.” Bedford, Massachusetts.

  • Melnick, Glenn, Jack Zwanziger, Anil Bamezai, and Robert Pattison. 1992. “The Effects of Market Structure and Bargaining Position on Hospital Prices.” Journal of Health Economics 11:217–233.

    Google Scholar 

  • Mulligan, James. 1985. “The Stochastic Determinants of Hospital Bed Supply.” Journal of Health Economics 4:177–185.

    Google Scholar 

  • Park, R.E. 1966. “Estimation with Heteroscedastic Error Terms.” Econometrica 34:888.

    Google Scholar 

  • Pauly, Mark, and Peter Wilson. 1986. “Hospital Output Forecasts and the Cost of Empty Hospital Beds.” Health Services Research 21:403–428.

    Google Scholar 

  • Prospective Payment Assessment Commission. June 1992. “Medicare and the Health Care System: Report to the Congress.” Washington, D.C.: ProPAC.

    Google Scholar 

  • Reinhardt, Uwe. 1996. “Spending More Through ‘Cost Control:’ Our Obsessive Quest to Gut the Hospital.” Health Affairs 15:145–154.

    Google Scholar 

  • Robinson, James, and Harold Luft. 1985. “The Impact of Hospital Market Structure on Patient Volume, Average Length of Stay, and the Cost of Care.” Journal of Health Economics 4:333–356.

    Google Scholar 

  • Thorpe, Kenneth. 1988. “Why are Urban Hospital Costs So High? The Relative Importance of Patient Source of Admission, Teaching, Competition, and Case Mix.” Health Services Research 22:821–836.

    Google Scholar 

  • Vita, Michael. 1990. “Exploring Hospital Production Relationships with Flexible Functional Forms.” Journal of Health Economics 9:1–21.

    Google Scholar 

  • Vitaliano, Donald. 1987. “On the Estimation of Hospital Cost Functions.” Journal of Health Economics 6:305–318.

    Google Scholar 

  • White, Stephen. 1987. “The Effects of Competition on Hospital Costs in Florida.” Policy Studies Journal 15:375–393.

    Google Scholar 

  • Zwanziger, Jack, and Glenn Melnick. 1988. “The Effects of Hospital Competition and the Medicare PPS Program on Hospital Cost Behavior in California.” Journal of Health Economics 7:301–319.

    Google Scholar 

  • Zwanziger, Jack, Glenn Melnick, and Kathleen Eyre. 1994. “Hospitals and Antitrust: Defining Markets, Setting Standards.” Journal of Health Politics, Policy and Law 19:423–447.

    Google Scholar 

Download references

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Carey, K. Stochastic Demand for Hospitals and Optimizing "Excess" Bed Capacity. Journal of Regulatory Economics 14, 165–188 (1998). https://doi.org/10.1023/A:1008009302343

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