| Summary: | 碩士 === 長庚大學 === 醫務管理學研究所 === 97 === This paper investigates the competition of hemodialysis industry in Taiwan and discusses how hemodialysis treatment providers deal with the changes in the market competition environment. Specifically, this paper uses a series of empirical model settings to understand how the hemodialysis treatment providers use the strategy of “market stealing” while confronting the change of market competition.
Dataset used is mainly from Taiwan’s National Health Insurance Research Dataset (NHIRD) covering from 1996 to 2001. The competition of a provider is measured by the number of hospitals (and clinics) located in the market where it resides at. The “market stealing” behavior of a hospital or clinic is characterized by the ratio of hemodialysis received by patients transferred from other providers (“half-new patients”) to that received by total number of patients in this provider. Furthermore, the empirical technique of first-difference is employed for controlling for the unobservable factors, such as the quality and convenience of traffic of a hospital or clinic.
Results are as follows. Firstly, one additional new entrant significantly increases the ratio of hemodialysis received by “half-new patients” to that by total patients in the provider by 0.0023%～0.0227%. This result is robust when we use different distance to measure the market In addition, this relationship is even clearer for private, lower ranked (clinics) and southern hospitals or clinics. Lastly, responding to one new market entrant, a hospital or clinic is usually “stealing” patients from providers with the same accreditation level (0.011%) or lower level(0.0012%)
Our findings show that the more competitive in a market, the more significant the phenomenon of “stealing” patients is. It also indicates a tough competition environment in the hemodialysis treatment industry in Taiwan. However, the impact of such competition on medical quality is unknown and is worth for further investigations. In addition, the authorities should pay attention to the competition in this industry while establishing related policy.
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