Competition Measurement of Hospitals in Poland: the Herfindahl-Hirschman Index Approach

Abstract

The purpose of this study was to measure the competition level of general hospitals in Poland. The Herfindahl-Hirschman Index (HHI) was used to investigate the concentration level of the general hospital sector in Poland, which is treated in the literature as a proxy of competition. To understand how general hospitals' market has been structured and thus competitive, the data for general hospitals spanning all Poland for the period of 2005-2013 were collected. The concentration of hospitals was measured in each of the 16 provinces in Poland based on the aggregated data at the counties level. Data are collected from the public statistical system. The HHI indices support the assertion that in the period of analysis the entire general hospitals' sector in Poland has been on average moderately concentrated and thus, moderately competitive with the growing tendency to higher concentration and less competition. Moreover, the concentration of hospitals' services is diversified across the provinces and regions of Poland and it is quite uneven. The analysis also shows that changes in the health care market, which took place in the analysed period, especially statutory changes regarding hospitals in 2011, affected the level of concentration and thus competition. Including this introduction, this paper is organized into six sections. Section 2 outlines the Polish health care reforms especially those applying to hospitals. Section 3 and 4 presents the concept of empirical research, such as data and method. Section 5 provides results of empirical research and section 6 concludes.

Socioeconomic Determinants of Health and Their Unequal Distribution in Poland

“…For the purposes of assessing the level of inequity of the analysed variables, the Herfindahl-Hirschman Index (HHI) [94] was also employed, which allows us to identify the level of inequity in the distribution of the socioeconomic determinants of health. It is commonly used in economics, health services research and other disciplines [95].…”

Income and Education as a Source of Health Inequality. New Ue Countries Case

“…Herfindahl (1950) and became an universally known index of market concentration used to determine the degree of competitiveness of a company [Ginevičius, Čirba 2007;Pan et al 2015], export [Meilak 2008], sea container transport market [Matczak 2016], banking services [Tushaj, Hashorva, Thano 2015]. It is a simple statistical measure which is more and more often borrowed, e.g., to calculate concentration of financial and non-financial resources in health protection as well as concentration of shares of all hospitals in the national and regional market [Rhoades 1993], in order to study inequalities in the structure of the hospital market [Rój 2016].…”

Inequality in the Distribution of Healthcare Human Resources in Poland

“…However, shortly after, in January 2004, the law on universal insurance in the National Health Fund was found as not standing in accordance with the Constitution. Therefore, the law on health benefits financed from public means was passed by the Sejm of the Republic of Poland at the end of July in 2004 [105], but the general idea of insurance and insurance institution of National Health Fund remained [106].…”