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

Author

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  • Devesh Raval
  • Ted Rosenbaum
  • Nathan E. Wilson

Abstract

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.

Suggested Citation

  • Devesh Raval & Ted Rosenbaum & Nathan E. Wilson, 2022. "Using disaster‐induced closures to evaluate discrete choice models of hospital demand," RAND Journal of Economics, RAND Corporation, vol. 53(3), pages 561-589, September.
    • Handle: RePEc:bla:randje:v:53:y:2022:i:3:p:561-589
    DOI: 10.1111/1756-2171.12421
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    References listed on IDEAS

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    1. Capps, Cory & Dranove, David & Satterthwaite, Mark, 2003. "Competition and Market Power in Option Demand Markets," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 737-763, Winter.
    2. Katherine Ho, 2006. "The welfare effects of restricted hospital choice in the US medical care market," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 21(7), pages 1039-1079.
    3. Kate Ho & Robin S. Lee, 2017. "Insurer Competition in Health Care Markets," Econometrica, Econometric Society, vol. 85, pages 379-417, March.
    4. Kate Ho & Robin S. Lee, 2019. "Equilibrium Provider Networks: Bargaining and Exclusion in Health Care Markets," American Economic Review, American Economic Association, vol. 109(2), pages 473-522, February.
    5. Joseph Farrell & David Balan & Keith Brand & Brett Wendling, 2011. "Economics at the FTC: Hospital Mergers, Authorized Generic Drugs, and Consumer Credit Markets," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 39(4), pages 271-296, December.
    6. Gautam Gowrisankaran & Aviv Nevo & Robert Town, 2015. "Mergers When Prices Are Negotiated: Evidence from the Hospital Industry," American Economic Review, American Economic Association, vol. 105(1), pages 172-203, January.
    7. Mark Shepard, 2022. "Hospital Network Competition and Adverse Selection: Evidence from the Massachusetts Health Insurance Exchange," American Economic Review, American Economic Association, vol. 112(2), pages 578-615, February.
    8. Beckert, Walter, 2018. "Choice in the presence of experts: The role of general practitioners in patients’ hospital choice," Journal of Health Economics, Elsevier, vol. 60(C), pages 98-117.
    9. Kelvin J. Lancaster, 1966. "A New Approach to Consumer Theory," Journal of Political Economy, University of Chicago Press, vol. 74(2), pages 132-132.
    10. Christopher Garmon, 2017. "The accuracy of hospital merger screening methods," RAND Journal of Economics, RAND Corporation, vol. 48(4), pages 1068-1102, December.
    11. Farrell Joseph & Shapiro Carl, 2010. "Antitrust Evaluation of Horizontal Mergers: An Economic Alternative to Market Definition," The B.E. Journal of Theoretical Economics, De Gruyter, vol. 10(1), pages 1-41, March.
    12. Kate Ho & Ariel Pakes, 2014. "Hospital Choices, Hospital Prices, and Financial Incentives to Physicians," American Economic Review, American Economic Association, vol. 104(12), pages 3841-3884, December.
    13. Devesh Raval & Ted Rosenbaum, 2021. "Why is Distance Important for Hospital Choice? Separating Home Bias From Transport Costs," Journal of Industrial Economics, Wiley Blackwell, vol. 69(2), pages 338-368, June.
    14. Kenneth I. Wolpin & Petra E. Todd, 2006. "Assessing the Impact of a School Subsidy Program in Mexico: Using a Social Experiment to Validate a Dynamic Behavioral Model of Child Schooling and Fertility," American Economic Review, American Economic Association, vol. 96(5), pages 1384-1417, December.
    15. Raval, Devesh & Rosenbaum, Ted & Wilson, Nathan E., 2021. "How do machine learning algorithms perform in predicting hospital choices? evidence from changing environments," Journal of Health Economics, Elsevier, vol. 78(C).
    16. Devesh Raval & Ted Rosenbaum & Steven A. Tenn, 2017. "A Semiparametric Discrete Choice Model: An Application To Hospital Mergers," Economic Inquiry, Western Economic Association International, vol. 55(4), pages 1919-1944, October.
    17. Martin S. Gaynor & Samuel A. Kleiner & William B. Vogt, 2013. "A Structural Approach to Market Definition With an Application to the Hospital Industry," Journal of Industrial Economics, Wiley Blackwell, vol. 61(2), pages 243-289, June.
    18. Katherine Ho, 2009. "Insurer-Provider Networks in the Medical Care Market," American Economic Review, American Economic Association, vol. 99(1), pages 393-430, March.
    19. Parag A. Pathak & Peng Shi, 2014. "Demand Modeling, Forecasting, and Counterfactuals, Part I," NBER Working Papers 19859, National Bureau of Economic Research, Inc.
    20. Devesh Raval & Ted Rosenbaum, 2018. "Why Do Previous Choices Matter for Hospital Demand? Decomposing Switching Costs from Unobserved Preferences," The Review of Economics and Statistics, MIT Press, vol. 100(5), pages 906-915, December.
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    Cited by:

    1. Abigail Ferguson & Nellie Lew & Michael Lipsitz & Devesh Raval, 2023. "Economics at the FTC: Spatial Demand, Veterinary Hospital Mergers, Rulemaking, and Noncompete Agreements," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 63(4), pages 435-465, December.

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