Marginal costs in general acute care hospitals: A comparison among California, New York and Canada

Health Economics

Volumn 5, Issue 3, 1996, Pages 195-216

  Hansen, Korinna K ^a   Zwanziger, Jack ^b  

^a WELLESLEY COLLEGE   (United States)

^b UNIVERSITY OF ROCHESTER MEDICAL CENTER   (United States)

Author keywords

Acute care production; Hospital costs; Marginal costs

Indexed keywords

ACUTE DISEASE; ARTICLE; CANADA; COMPARATIVE STUDY; ECONOMICS; GENERAL HOSPITAL; HEALTH CARE FACILITY; HEALTH SERVICES RESEARCH; HOSPITAL COST; HOSPITAL MANAGEMENT; HUMAN; LENGTH OF STAY; REGRESSION ANALYSIS; STATISTICAL MODEL; STATISTICS; UNITED STATES;

ACUTE DISEASE; BRITISH COLUMBIA; CALIFORNIA; HEALTH FACILITY SIZE; HEALTH SERVICES RESEARCH; HOSPITAL COSTS; HOSPITALS, GENERAL; HUMANS; LENGTH OF STAY; MODELS, ECONOMIC; NEW YORK; ONTARIO; PRODUCT LINE MANAGEMENT; REGRESSION ANALYSIS;

EID: 0030136394     PISSN: 10579230     EISSN: None     Source Type: Journal    
DOI: 10.1002/(SICI)1099-1050(199605)5:3<195::AID-HEC201>3.0.CO;2-Q     Document Type: Article

References (19)

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17. Because of the limited number of hospitals in each 'quartile' a separate GLS estimation for each 'quartile' is not feasible. Instead, we use the parameter estimates from the initial estimation that included all hospitals but mean values and weights from only the relevant range of hospitals each time.
18. We also used the raw estimates of hospital marginal costs given by equation (2), to study their distribution jointly with hospital output. We graphed estimated conditional density functions of hospital marginal costs for low-, medium- and high-volume hospitals conditional on hospital output volume. Overall, the estimates suggest that lower volume hospitals in all jurisdictions and for all outputs (acute and intensive care and hospital visits) exhibit a tighter distribution of hospital marginal costs, and high-volume hospitals a more dispersed distribution. We also can find only weak scale effects in acute and intensive care production. Canadian high-volume hospitals appear to enjoy positive scale effects in acute care production but negative scale effects in intensive care production. Hospitals in New York experienced weak negative scale effects in acute care production and in California positive scale effects in intensive care production. These results are in agreement with our average marginal cost estimates per 'quartile'.
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