Hospital–Physician Affiliations and Patient Treatments, Expenditures, and Outcomes

Kristin M. Madison

85 citations0/0 files storedHealth Services Research

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Healthcare Policy and Management Health Services Management and Policy Healthcare Quality and Management

Abstract

OBJECTIVE: To determine the relationship between hospital-physician affiliations and the treatments, expenditures, and outcomes of patients. DATA SOURCES: Sources include the Medicare Provider Analysis and Review dataset, the American Hospital Association (AHA) Annual Survey, and the Area Resource File (ARF). STUDY DESIGN: A multivariate regression analysis of the relationship between hospital-physician affiliations (such as physician-hospital organizations [PHOs] or salaried employment) and the treatment of Medicare patients with a diagnosis of acute myocardial infarction admitted to general medical-surgical hospitals between 1994 and 1998. Dependent variables include whether the patient received a catheterization or angioplasty or bypass surgery; whether a patient was readmitted, or died within 90 days of initial admission; and expenditures. Independent variables include patient, admission hospital, and market characteristics, as well as hospital and year fixed effects. PRINCIPAL FINDINGS: The integrated salary model form of hospital-physician affiliation is associated with slightly higher procedure rates, and higher patient expenditures. At the same time, there is little evidence that hospital-physician affiliations in the aggregate have had any measurable impact on patient treatment or outcomes. CONCLUSIONS: The limited effect of hospital-physician affiliations on patient outcomes is consistent with previous research showing that affiliations have not much changed the nature of health care delivery. However, the finding that the integrated salary model is associated with higher treatment intensity suggests that affiliations may have had some impact on patients, and could have more in the future.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 85 citations exist upstream.

References

1986The Economic Institutions of Capitalism 2000Is Hospital Competition Socially Wasteful?2002Integrated Delivery Networks: A Detour On The Road To Integrated Health Care?2005Strategic integration of hospitals and physicians 1995The effects of hospital-physician integration strategies on hospital financial performance.2005The effect of physician–hospital affiliations on hospital prices in California 1997Physician-Hospital Integration and the Economic Theory of the Firm

Cited by

2011Competition in Health Care Markets11We wish to thank participants at the Handbook of Health Economics meeting in Lisbon, Portugal, Pedro Pita Barros, Rein Halbersman, and Cory Capps for helpful comments and suggestions. Misja Mikkers, Rein Halbersma, and Ramsis Croes of the Netherlands Healthcare Authority graciously provided data on hospital and insurance market structure in the Netherlands. David Emmons kindly provided aggregates of the American Medical Association's calculations of health insurance market structure. Leemore Dafny was kind enough to share her measures of market concentration for the large employer segment of the US health insurance market. All opinions expressed here and any errors are the sole responsibility of the authors. No endorsement or approval by any other individuals or institutions is implied or should be inferred.2013Performance impacts of interorganizational cooperation: a transaction cost perspective

Explore the map →

Papers that cite the same references — the relational fallback while embeddings are still backfilling.

Imported from OpenAlex (CC0) — nothing here is generated.