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Four Essays on the Dialysis Industry

Four Essays on the Dialysis Industry. Jon M Ford, PhD School of Economics And Trade College Of Economics and Business Administration Kyungpook National University. (1) Ownership Structure and the Quality of Medical Care: Evidence from the Dialysis Industry.

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Four Essays on the Dialysis Industry

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  1. Four Essays on the Dialysis Industry Jon M Ford, PhD School of Economics And Trade College Of Economics and Business Administration Kyungpook National University

  2. (1) Ownership Structure and the Quality of Medical Care: Evidence from the Dialysis Industry • We used patient treatment level data from 1972-present (n=2389) • People with kidney failure must undergo dialysis treatments 3 times per week, Medicare pays $128 per treatment • We looked at the impact of ownership (e.g. not-for-profit, NFP) on the quality of care (e.g. length-of-run, LRUN) • We found that NFP firms used significantly longer LRUN times for their patients on the dialysis machines • Published with David Kaserman in the Journal of Economic Behavior & Organization, vol 43, year 2000, pp 279-293

  3. (2) Treatment Modality and the Quality of Life of Dialysis Patients: Evidence from Suicide Rates • We used patient level data from 1972-present (n=454,076) • Suicide rates among dialysis patients is 100x greater than that of the general population • People with kidney failure must undergo one of two types of dialysis treatments (hemodialysis or peritoneal dialysis) • We looked at the impact of modality (e.g. hemodialysis, HD) on the quality of life (e.g. suicide rates, SUICIDE) using a Heckman selection model • We found that HD patients had significantly longer SUICIDE and if we move 1000 patients from PD to HD then avoid 141 suicides could be avoided, at a cost of $42,043 each • Published with David Kaserman in the Contemporary Economic Policy, vol 18, year 2000, pp 440-448

  4. (3) Certificate-of-Need Regulation and Entry: Evidence from the Dialysis Industry • We used state level data from 1981-1989 (n=400) • To open or expand a dialysis clinic one must apply for a state regulated certificate-of-need (CON) • In 1981 there were 1,041 clinics with 12,329 stations but by 1989 there were 1,830 clinics with 23,654 stations • We used two measures of entry; (1) number of clinic, E1 and (2) number of stations, E2. • We found that CON significantly restricted entry as measure by both E1 and E2 • Published with David Kaserman in the Southern Economic Journal, vol 59, year 1993, pp 783-791

  5. (4) Certificate-of-Need Regulation and the Diffusion of New Innovations: A Random Coefficient Model • We used state (i) level data over time (t) from 1977-1990 (n=700) • To open or expand a dialysis clinic one must apply for a state regulated certificate-of-need (CON) • We estimated the following random coefficient model ln((Pit/(Li-Pit)) = ai + ciT +diT*CONit + eit • We found that CON significantly slows the rate of diffusion of hemodialysis • Published with Steven Caudill and David Kaserman in the Journal of Applied Econometrics, vol 10, year 1995, pp 73-78

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