Cost reductions or reputation enhancement as motives for mergers: The logic of multihospital systems
研究了地方多医院系统形成的两个动机：成本降低和声誉提升。发现系统医院并未降低成本，但相比非系统医院享有声誉优势，这对卫生改革假设提出了挑战。
Abstract This paper examines two motives for the formation of local multihospital systems: cost reduction and reputation enhancement. Systems may reduce costs by eliminating redundancies and reducing administrative costs. Integration may also lower costs for consumers seeking consistently high qualiiy. We hypothesize that if systems achieve either cost or reputation benefits, then member hospitals will ‘look’ different from random collections of hospitals. We find that local systems do not appear to have lower costs but do appear to enjoy reputation benefits over nonsystem hospitals. Our findings challenge the assumptions behind popular health reform initiatives.