Assessing Competition in Hospital Care Markets: The Importance of Accounting for Quality Differentiation
强调质量差异化在医院市场中的重要性，通过随机系数离散选择模型估计患者对距离和质量的反应，发现地理市场集中度不适合衡量医院竞争力。
Quality differentiation is especially important in the hospital industry, where the choices of Medicare patients are unaffected by prices. Unlike previous studies that use geographic market concentration to estimate hospital competitiveness, this article emphasizes the importance of quality differentiation in this spatially differentiated market. I estimate a random-coefficients discrete-choice model that predicts patient flow to different hospitals and find that demand responses to both distance and quality are substantial. The estimates suggest that patients do not substitute toward alternative hospitals in proportion to current market shares, implying that geographic market concentration is an inappropriate measure of hospital competitiveness.