Strategic behaviour and decision making in competitive hospital markets: an experimental investigation.

IF 1.5 4区 经济学 Q3 BUSINESS, FINANCE International Journal of Health Economics and Management Pub Date : 2024-09-01 Epub Date: 2024-03-15 DOI:10.1007/s10754-024-09366-3
Johann Han, Nadja Kairies-Schwarz, Markus Vomhof
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Abstract

We investigate quality provision and the occurrence of strategic behaviour in competitive hospital markets where providers are assumed to be semi-altruistic towards patients. For this, we employ a laboratory experiment with a hospital market framing. Subjects decide on the quality levels for one of three competing hospitals respectively. We vary the organizational aspect of whether quality decisions within hospitals are made by individuals or teams. Realized monetary patient benefits go to real patients outside the lab. In both settings, we find that degrees of cooperation quickly converge towards negative values, implying absence of collusion and patient centred or competitive quality choices. Moreover, hospitals treat quality as a strategic complement and adjust their quality choice in the same direction as their competitors. The response magnitude for team markets is weaker; this is driven by non-cooperative or altruistic teams, which tend to set levels of quality that are strategically independent.

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竞争性医院市场中的战略行为和决策:一项实验研究。
我们研究了竞争性医院市场中的质量提供和战略行为的发生,假定提供者对病人是半利他主义的。为此,我们采用了一个医院市场框架实验室实验。实验对象分别决定三家竞争医院中一家的质量水平。我们改变了医院的组织结构,即医院内的质量决策是由个人还是团队做出的。已实现的患者货币收益将转给实验室外的真实患者。我们发现,在这两种情况下,合作程度都会迅速向负值靠拢,这意味着不存在串通和以患者为中心或竞争性的质量选择。此外,医院将质量视为一种战略补充,并与竞争对手一样调整其质量选择。团队市场的反应幅度较弱;这是由非合作或利他主义团队驱动的,他们倾向于设定独立于战略的质量水平。
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来源期刊
CiteScore
3.60
自引率
0.00%
发文量
18
期刊介绍: The focus of the International Journal of Health Economics and Management is on health care systems and on the behavior of consumers, patients, and providers of such services. The links among management, public policy, payment, and performance are core topics of the relaunched journal. The demand for health care and its cost remain central concerns. Even as medical innovation allows providers to improve the lives of their patients, questions remain about how to efficiently deliver health care services, how to pay for it, and who should pay for it. These are central questions facing innovators, providers, and payers in the public and private sectors. One key to answering these questions is to understand how people choose among alternative arrangements, either in markets or through the political process. The choices made by healthcare managers concerning the organization and production of that care are also crucial. There is an important connection between the management of a health care system and its economic performance. The primary audience for this journal will be health economists and researchers in health management, along with the larger group of health services researchers. In addition, research and policy analysis reported in the journal should be of interest to health care providers, managers and policymakers, who need to know about the pressures facing insurers and governments, with consequences for regulation and mandates. The editors of the journal encourage submissions that analyze the behavior and interaction of the actors in health care, viz. consumers, providers, insurers, and governments. Preference will be given to contributions that combine theoretical with empirical work, evaluate conflicting findings, present new information, or compare experiences between countries and jurisdictions. In addition to conventional research articles, the journal will include specific subsections for shorter concise research findings and cont ributions to management and policy that provide important descriptive data or arguments about what policies follow from research findings. The composition of the editorial board is designed to cover the range of interest among economics and management researchers.Officially cited as: Int J Health Econ ManagFrom 2001 to 2014 the journal was published as International Journal of Health Care Finance and Economics. (Articles published in Vol. 1-14 officially cited as: Int J Health Care Finance Econ)
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