Certificate-of-need (CON) laws are intended to restrain health care spending by limiting the acquisition of duplicative capital and the initiation of unnecessary services. Critics contend that need is difficult to objectively assess, especially considering the risks and uncertainty inherent in...

We seek to estimate the effects of competition for both Medicare and HMO patients on the quality decisions of hospitals in Southern California. We find that increases in the degree of competition for HMO patients decrease risk-adjusted hospital mortality rates. Conversely, increases in...

This paper develops new econometric methods to estimate hospital quality and other models with discrete dependent variables and non-random selection. Mortality rates in patient discharge records are widely used to infer hospital quality. However, hospital admission is not random and some...