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Quality Choice And Market Structure: A Dynamic Analysis Of Nursing Home Oligopolies

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  • Haizhen Lin

Abstract

This article develops a dynamic model of entry and exit to analyze quality choice and oligopoly market structure in the nursing home industry. I find significant heterogeneity in the competitive effects across market structures: Firms of similar quality levels compete more strongly than dissimilar firms. Sunken entry costs are extremely large, and quality adjustment behavior is governed by significant fixed adjustment costs. A proposal to eliminate low‐quality nursing homes is found to cause a large supply‐side shortage, and another proposal to lower entry costs has offered a perverse incentive to provide low quality of care.

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  • Haizhen Lin, 2015. "Quality Choice And Market Structure: A Dynamic Analysis Of Nursing Home Oligopolies," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 56(4), pages 1261-1290, November.
    • Handle: RePEc:wly:iecrev:v:56:y:2015:i:4:p:1261-1290
    DOI: 10.1111/iere.12137
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    5. Victor Aguirregabiria & Mathieu Marcoux, 2021. "Imposing equilibrium restrictions in the estimation of dynamic discrete games," Quantitative Economics, Econometric Society, vol. 12(4), pages 1223-1271, November.
    6. Jianjing Lin, 2023. "To follow the market or the parent system: Evidence from health IT adoption by hospital chains," Economic Inquiry, Western Economic Association International, vol. 61(4), pages 891-910, October.
    7. Susan Feng Lu & Konstantinos Serfes & Gerard Wedig & Bingxiao Wu, 2021. "Does Competition Improve Service Quality? The Case of Nursing Homes Where Public and Private Payers Coexist," Management Science, INFORMS, vol. 67(10), pages 6493-6512, October.
    8. Remco van Eijkel & Mark Kattenberg & Ab van der Torre, 2018. "Competition and pricing behavior in long term care markets: Evidence from the Market for Assistance in Daily Housekeeping Activities," CPB Discussion Paper 373, CPB Netherlands Bureau for Economic Policy Analysis.
    9. Remco Eijkel & Mark Kattenberg & Ab Torre, 2023. "Pricing behavior in long term care markets: evidence from provider-level data for home help services," International Journal of Health Economics and Management, Springer, vol. 23(1), pages 59-83, March.
    10. Michael Alexeev & Ivan Dedyukhin & Leonid Polishchuk, 2024. "Ownership, Asymmetric Information, and Quality of Care for the Elderly: Evidence from US Nursing Homes During the COVID-19 Pandemic," CAEPR Working Papers 2024-006 Classification-, Center for Applied Economics and Policy Research, Department of Economics, Indiana University Bloomington.
    11. Yanfei Wang, 2022. "Competition And Multilevel Technology Adoption: A Dynamic Analysis Of Electronic Medical Records Adoption In U.S. Hospitals," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(3), pages 1357-1395, August.

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