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This study investigated whether the type of hospital in which a Medicare beneficiary is admitted for hip fracture, stroke, coronary heart disease, or congestive heart failure matters in terms of amount and timing of Medicare payments and survival. In total, government hospitals were the least expensive for Medicare, with major teaching hospitals being most expensive within 6 months of admission after the index even. Survival was best in major teaching hospitals. When considering payments subsequent to those for the initial hospitalization, Medicare spent more for patients admitted to for-profit hospitals than for those admitted to other non-teaching facilities survival. Payments on behalf of patients treated in for-profit hospitals were higher for Medicare Part B and home health, especially during the first two months following discharge from the initial hospital. Results of our research suggest that Medicare has a definite financial interest in where Medicare beneficiaries are admitted for their hospital care.

Hospital care --- Older people --- Evaluation. --- Hospital care.

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Applying principles of merger evaluation to the health care industry in general, and to hospital markets in particular, poses several unique challenges. Definition of relevant geographic markets and assessment of the consequences of changes in competition for patient and social welfare are complicated by asymmetric information and moral hazard due to health insurance. We suggest a new empirical approach to assessing the impact of hospital competition which addresses the shortcomings of existing methods. We then summarize our main results on the welfare consequences of competition. We conclude with an illustration of how our methods can be used to assess the welfare implications of specific hospital mergers, and with some implications of our findings for antitrust policy.

Hospital care --- Medical economics. --- Evaluation.

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Psychiatric hospital care --- Psychiatric hospitals --- Hôpitaux psychiatriques --- History --- Soins --- Histoire

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Medicare --- Older people --- Hospitals --- Finance. --- Hospital care --- Rehabilitation services --- Prospective payment --- United States. --- Medical --- Social science

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Nosocomial infections --- Resuscitation --- Hospital care --- Infections nosocomiales --- Réanimation --- Soins hospitaliers --- Prevention --- Quality --- Control --- Prévention --- Qualité --- Contrôle