Structural change in the hospital industry : community level competition in Texas hospitals /
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| Other Authors: | , , |
| Format: | Thesis Book |
| Language: | English |
| Published: |
1988.
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| Subjects: | |
| Online Access: | ProQuest, Abstract Link to OAKTrust copy |
| Abstract: | The purposes of the study were to identify the effects of the relatively high concentration of investor-owned hospitals in Texas upon the distribution of hospital care provided at less than full charge and to examine the market-share performance of hospitals of different ownership types under conditions of increased competition. Between 1979 and 1984 hospital admissions and length-of-stay reversed their established growth trends, alternatives to traditional hospital-based care flourished, and competition between hospitals rapidly intensified in response to falling occupancy levels. Hospital level data were taken from the Texas Department of Health's Annual Survey of Hospitals for the years 1979, 1981, 1983 and 1984. Data on Texas hospital closures and Medicaid eligibles were obtained from the Texas Hospital Association and the Texas Department of Human Services. The sample included 377 short stay community hospitals. The percent of a hospital's admissions that were Medicaid patients was used as a proxy measure for care provided at less than full charge. Public hospitals in counties in which investor-owned hospitals had increased their share of total beds in the county between 1979 and 1984 were examined for the anticipated response of higher concentrations of Medicaid patients. The correlation between change in percentage of investor-owned beds in the county and concentration of Medicaid patients was present, but not significant. The proportion of Medicaid admissions relative to total admissions increased with county population for all ownership types. Investor-owned hospitals demonstrated slightly declining market shares (of admissions) between 1979 and 1984. Public hospitals maintained their market shares against both for-profit facilities and other forms of not-for-profit ownership. Investor-owned hospitals have accounted for 58% of all hospital closures in the last five years. The average size of hospitals at time of closure was 33-35 beds and shows no sign of increasing. The characteristics of Texas hospitals at time of closure match those in studies of other states. |
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| Item Description: | Typescript (photocopy.). Vita. "Major Subject: Urban and Regional Science." |
| Physical Description: | ix, 114 leaves : illustrations ; 29 cm |
| Bibliography: | Includes bibliographical references (leaves 100-103). |