Variation in markup of general surgical procedures by hospital market concentration - 20/03/18
Abstract |
Background |
Increasing hospital market concentration (with concomitantly decreasing hospital market competition) may be associated with rising hospital prices. Hospital markup – the relative increase in price over costs – has been associated with greater hospital market concentration.
Methods |
Patients undergoing a cardiothoracic or gastrointestinal procedure in the 2008–2011 Nationwide Inpatient Sample (NIS) were identified and linked to Hospital Market Structure Files. The association between market concentration, hospital markup and hospital for-profit status was assessed using mixed-effects log-linear models.
Results |
A weighted total of 1,181,936 patients were identified. In highly concentrated markets, private for-profit status was associated with an 80.8% higher markup compared to public/private not-for-profit status (95%CI: +69.5% - +96.9%; p < 0.001). However, private for-profit status in highly concentrated markets was associated with only a 62.9% higher markup compared to public/private not-for-profit status in unconcentrated markets (95%CI: +45.4% - +81.1%; p < 0.001).
Conclusion |
Hospital for-profit status modified the association between hospitals' market concentration and markup. Government and private not-for-profit hospitals employed lower markups in more concentrated markets, whereas private for-profit hospitals employed higher markups in more concentrated markets.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Hospital market concentration has been linked to variation in costs for surgery. |
• | Overall median markup of adjusted costs for procedures was 85%. |
• | Private insurance was associated with 7.1% lower adjusted markup. |
• | Hospital for-profit status had variable effects on markup across different markets. |
Keywords : Hospital markets, Procedural markup, General surgery
Plan
Vol 215 - N° 4
P. 549-556 - avril 2018 Retour au numéro
Article précédent
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