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12 Cards in this Set
- Front
- Back
What are the different modes of hospital-physician relationships? What are the tradeoffs of these modes? |
-“Physicians’ workbench”(Majority in US): Physicians not directly employed by hospital -Direct employees (UK NHS; US “hospitalists”) - Physician-owned hospitals (Japan; US) -Physician loyalty to hospital or the patient? -Doctors without connection to the hospital may overuse hospital resources and have lower incentives to control hospital costs (e.g. with respect to technology adoption) |
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What are the different models of hospital behaviour? |
- The Profit-Maximizing Hospital - A Model of a Private Not-for-profit Hospital - Not-for-Profit Hospital as a Physicians’ Cooperative |
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What is the only relevant factor to profit-maximizing hospitals? |
Only quantity of service is a decision variable |
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What is the particularity when quality comes into account? |
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What are the benefits and costs of NFP institutions? |
- Benefits of nonprofit status: -Exempt from taxes - Donors receive a tax deduction - Costs of nonprofit status: - Cannot sell stock - Cannot distribute profits to owners -Restricted to certain charitable activities |
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What is the newhouse model (NFP)? |
Hospital maximizes its utility subject to a constraint. - Utility depends on the amount of quantity and quality the hospital provides. Let U=U(x,y) - Constraint: Zero-profit constraint |
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What is the Quantity-Quality frontier? |
Combinations of quantity and quality where the hospital's profit is zero. |
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How do hospitals maximize their utility? |
The hospital maximizes utility given the quality-quantity possibility frontier - Highest attainable indifference curve is 𝐼𝑜 |
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What defines the quality of a hospital? |
- Sophisticated services - Nurse staffing -Facilities and services offered -Hospitals’ credentials - Mortality rates - Rehospitalization rates - Change in functional status, in cognitive status - Process of care (chart reviews) |
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What is the Pauly-Redisch Model (physicians' cooperative)? |
-Doctors exercise important influence on hospital decision-making - Trustees merely legitimize hospital actions - Some medical staffs are “closed” |
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How is the break even formulated for these cooperatives? |
px = wL +cK + yMM where p is the demand(in price) x is the quantity w is the wage of labor L is the amount of staff c is the cost associated with the capital K yM is the wage associated to the number of physicians M |
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How is the optimal strategy chosen? |
For best quality the wages of the doctor must be maximized. yM is derived with the number of labour and the number of physicians and optimized according to the supply. |