High-powered reimbursement systems such as capped budgets or prospective payment systems offer powerful incentives to hospitals to reduce their expenses, particularly in high cost areas such as operating rooms (ORs). Specialization is one prominent response strategy to such pressures. This study...

Background: In most developed countries, the past 30 years have witnessed a tremendous increase in the economic pressure put on hospitals by governments to increase their efficiency. While there is little doubt that high-powered reimbursement systems like capped budgets or prospective payment...