Entry of Freestanding Emergency Departments in Texas – A series of Economic Studies

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dc.contributor.advisorHo, Vivianen_US
dc.creatorXu, Yingyingen_US
dc.date.accessioned2019-08-01T20:24:40Zen_US
dc.date.available2019-08-01T20:24:40Zen_US
dc.date.created2019-08en_US
dc.date.issued2019-07-19en_US
dc.date.submittedAugust 2019en_US
dc.date.updated2019-08-01T20:24:40Zen_US
dc.description.abstractThis dissertation consists of three essays which examine the location choice and emergency care market competition with the entry of freestanding emergency departments (FrEDs) in Texas, U.S.A. As the innovative health care facilities, Texas is the first state introducing the licensing act for FrEDs and has the highest number of FrEDs among all states by the end of 2018. The first paper investigates whether FrEDs open in areas of high need, or areas that yield high profit. Using logistic regressions, I find FrEDs in 2016 were more likely to be in high-income areas with high percentage of private insurers. The second paper explores whether the entry of FrEDs has been associated with less congestion in hospital-based emergency departments. By examining annual visits, wait time, length of visit and drop-out rate in hospital-based emergency departments from 2010 to 2016, the work concludes that the entry of FrEDs did not help relieve hospital congestion. The third paper examines visits in local markets and changes in patient casemix after the entry of FrEDs, to show market competition between different emergency care providers. I conclude that newly introduced FrEDs not only served as substitutes to hospital EDs, but also expanded the emergency services market. Low-acuity and well-insured patients were more likely to be diverted to nearby FrEDs from hospitals. Overall, this work helps understand the role of FrEDs in the healthcare market. Findings will guide future licensing requirements, state healthcare budget and potential customer protections in the United States.en_US
dc.format.mimetypeapplication/pdfen_US
dc.identifier.citationXu, Yingying. "Entry of Freestanding Emergency Departments in Texas – A series of Economic Studies." (2019) Diss., Rice University. <a href="https://hdl.handle.net/1911/106164">https://hdl.handle.net/1911/106164</a>.en_US
dc.identifier.urihttps://hdl.handle.net/1911/106164en_US
dc.language.isoengen_US
dc.rightsCopyright is held by the author, unless otherwise indicated. Permission to reuse, publish, or reproduce the work beyond the bounds of fair use or other exemptions to copyright law must be obtained from the copyright holder.en_US
dc.subjectMarket Competitionen_US
dc.subjectFirm Entryen_US
dc.subjectHealthcare Policyen_US
dc.titleEntry of Freestanding Emergency Departments in Texas – A series of Economic Studiesen_US
dc.typeThesisen_US
dc.type.materialTexten_US
thesis.degree.departmentEconomicsen_US
thesis.degree.disciplineSocial Sciencesen_US
thesis.degree.grantorRice Universityen_US
thesis.degree.levelDoctoralen_US
thesis.degree.nameDoctor of Philosophyen_US
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