文章基本信息

标题：Hospital competition with soft budgets
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作者：Kurt R. Brekke ; Luigi Siciliani ; Odd Rune Straume 等
期刊名称：Discussion Papers / Norwegian School of Economics and Business Administration
印刷版ISSN：0804-6824
出版年度：2012
卷号：2012
出版社：Bergen
摘要：We study the incentives for hospitals to provide quality and expend cost-reducing effort when their budgets are soft, i.e., the payer may cover deficits or confiscate surpluses. The basic set up is a Hotelling model with two hospitals that differ in location and face demand uncertainty, where the hospitals run deficits (surpluses) in the high (low) demand state. Softer budgets reduce cost efficiency, while the effect on quality is ambiguous. For given cost efficiency, softer budgets increase quality since parts of the expenditures may be covered by the payer. However, softer budgets reduce cost-reducing effort and the profit margin, which in turn weakens quality incentives. We also find that profit confiscation reduces quality and cost-reducing effort. First best is achieved by a strict no-bailout and no-profit-confiscation policy when the regulated price is optimally set. However, for suboptimal prices a more lenient bailout policy can be welfare improving.
关键词：Hospital competition; Soft budgets; Quality; Cost efficiency