Using disaster-induced closures to evaluate discrete choice models of hospital demand

• 成果类型: Article
• 署名作者: Raval, Devesh; Rosenbaum, Ted; Wilson, Nathan E.
• 刊物名称: RAND JOURNAL OF ECONOMICS
• ISSN/ISSBN: 0741-6261
• DOI: 10.1111/1756-2171.12421
• 发表日期: 2022
• 页码: 561-589
• 关键词: provider networks; COMPETITION; prices; COSTS

摘要

Although diversion ratios are important inputs to merger evaluation, there is little evidence about how accurately discrete choice models predict diversions. Using a series of natural disasters that unexpectedly closed hospitals, we compare observed post-disaster diversion ratios to those predicted from pre-disaster data using standard models of hospital demand. We find that all standard models consistently underpredict large diversions. Both unobserved heterogeneity in preferences over travel and post-disaster changes to physician practice patterns can explain some of the underprediction of large diversions. We find a significant improvement using models with a random coefficient on distance.