IS DUMPING SOCIALLY INEFFICIENT - AN ANALYSIS OF THE EFFECT OF MEDICARES PROSPECTIVE PAYMENT SYSTEM ON THE UTILIZATION OF VETERANS-AFFAIRS INPATIENT SERVICES
成果类型：
Article
署名作者：
EZE, P; WOLFE, B
署名单位：
University of Wisconsin System; University of Wisconsin Madison; Clark University
刊物名称：
JOURNAL OF PUBLIC ECONOMICS
ISSN/ISSBN：
0047-2727
DOI：
10.1016/0047-2727(93)90038-U
发表日期：
1993
页码：
329-344
关键词：
摘要：
This paper investigates an efficiency implication of Medicare's prospective payment system (PPS) on the utilization of United States Veterans Affairs (VA) hospital inpatient services by elderly veterans. There is empirical evidence to suggest that non-VA hospitals are reacting to PPS by increasingly shifting veterans they expect may be high-cost to VA hospitals. We define as efficient, allocations that would occur if hospitals acted as perfect agents of the patient, then we show that some shifting would still occur if allocations were efficient. This is because VA and non-VA hospitals operate under different budget regimes, and within each diagnosis related group, veterans with different levels of illness severity (and different non-VA insurance packages) will self-select into VA and non-VA hospitals. We derive conditions of severity under which different hospital types become attractive to particular patients.
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