Skip to main content
Health Services Research logoLink to Health Services Research
. 1999 Feb;33(6):1651–1668.

Excess capacity: markets regulation, and values.

C W Madden 1
PMCID: PMC1070341  PMID: 10029502

Abstract

OBJECTIVE: To examine the conceptual bases for the conflicting views of excess capacity in healthcare markets and their application in the context of today's turbulent environment. STUDY SETTING: The policy and research literature of the past three decades. STUDY DESIGN: The theoretical perspectives of alternative economic schools of thought are used to support different policy positions with regard to excess capacity. Changes in these policy positions over time are linked to changes in the economic and political environment of the period. The social values implied by this history are articulated. DATA COLLECTION: Standard library search procedures are used to identify relevant literature. PRINCIPAL FINDINGS: Alternative policy views of excess capacity in healthcare markets rely on differing theoretical foundations. Changes in the context in which policy decisions are made over time affect the dominant theoretical framework and, therefore, the dominant policy view of excess capacity. CONCLUSIONS: In the 1990s, multiple perspectives of optimal capacity still exist. However, our evolving history suggests a set of persistent values that should guide future policy in this area.

Full text

PDF
1655

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ashby J. L., Jr The impact of hospital regulatory programs on per capita costs, utilization, and capital investment. Inquiry. 1984 Spring;21(1):45–59. [PubMed] [Google Scholar]
  2. Brown L. D. Common sense meets implementation: certificate-of-need regulation in the states. J Health Polit Policy Law. 1983 Fall;8(3):480–494. doi: 10.1215/03616878-8-3-480. [DOI] [PubMed] [Google Scholar]
  3. Burda D. CONspiracies to crush competition. Hospitals using CON laws to thwart rival's projects. Mod Healthc. 1991 Jul 8;21(27):28-30, 32-4, 36. [PubMed] [Google Scholar]
  4. Burke M. Teaching hospitals brace for huge GME payment losses. Hospitals. 1990 Jul 5;64(13):36, 38, 40-2. [PubMed] [Google Scholar]
  5. Duke K. S. Hospitals in a changing health care system. Health Aff (Millwood) 1996 Summer;15(2):49–61. doi: 10.1377/hlthaff.15.2.49. [DOI] [PubMed] [Google Scholar]
  6. Levit K. R., Lazenby H. C., Sivarajan L. Health care spending in 1994: slowest in decades. Health Aff (Millwood) 1996 Summer;15(2):130–144. doi: 10.1377/hlthaff.15.2.130. [DOI] [PubMed] [Google Scholar]
  7. Lichiello P., Madden C. W. Context and catalysts for change in health care markets. Health Aff (Millwood) 1996 Summer;15(2):121–129. doi: 10.1377/hlthaff.15.2.121. [DOI] [PubMed] [Google Scholar]
  8. Miller R. H. Competition in the health system: good news and bad news. Health Aff (Millwood) 1996 Summer;15(2):107–120. doi: 10.1377/hlthaff.15.2.107. [DOI] [PubMed] [Google Scholar]
  9. Reinhardt U. E. Reorganizing the financial flows in American health care. Health Aff (Millwood) 1993;12 (Suppl):172–193. doi: 10.1377/hlthaff.12.suppl_1.172. [DOI] [PubMed] [Google Scholar]
  10. Robinson J. C., Luft H. S. The impact of hospital market structure on patient volume, average length of stay, and the cost of care. J Health Econ. 1985 Dec;4(4):333–356. doi: 10.1016/0167-6296(85)90012-8. [DOI] [PubMed] [Google Scholar]
  11. Salkever D. S., Bice T. W. The impact of certificate-of need controls on hospital investment. Milbank Mem Fund Q Health Soc. 1976 Spring;54(2):185–214. [PubMed] [Google Scholar]
  12. Simpson J. B. State certificate-of-need programs: the current status. Am J Public Health. 1985 Oct;75(10):1225–1229. doi: 10.2105/ajph.75.10.1225. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust

RESOURCES