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Effect of market competition on hospital performance for heart failure

Jared Lane K Maeda1, Anthony T LoSasso

  • 1Thomson Reuters, Healthcare Business Section, Analytic Consulting and Research Services, Washington, DC, USA. jared.maeda@thomsonreuters.com

The American Journal of Managed Care
|January 6, 2012
PubMed

Insights

Market competition shows minimal impact on hospital heart failure care quality. Less competitive markets performed slightly better on some indicators, but overall benefits were marginal.

Area of Science:

  • Health Services Research
  • Health Economics
  • Quality Improvement

Background:

  • Market competition is theorized to improve healthcare quality.
  • Its impact on hospital performance for specific conditions like heart failure (HF) requires investigation.

Purpose of the Study:

  • To examine the relationship between healthcare market competition and hospital performance on key evidence-based heart failure quality indicators.

Main Methods:

  • Retrospective analysis of hospital performance data (2003-2006) from The Joint Commission's ORYX program.
  • Data linked with hospital characteristics and area-level sociodemographic information.
  • Used ordinary least squares fixed effects regression models to assess market competition intensity (Herfindahl-Hirschman Index) and hospital performance.

Main Results:

  • Hospital performance on heart failure quality indicators significantly changed over time.
  • Hospitals in less competitive markets showed slightly better performance in left ventricular function assessment (2.9% higher).
  • Conversely, less competitive markets performed moderately worse (5.1% lower) on discharge instructions.

Conclusions:

  • Market competition intensity demonstrated only minor associations with hospital performance in heart failure care.
  • The level of market competitiveness offers marginal incremental benefits to inpatient heart failure care quality.
Abstract

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