<p>My dissertation focuses on employing microeconomic techniques to study markets and questions that are important and complex, and also have potential policy implications. Two of my chapters analyze the health industry with an emphasis on hospitals, patient welfare, and regulation. The remaining chapter focuses on the housing market in Los Angeles and explores real estate flipping.</p><p>The second chapter of my dissertation studies the impact of state level regulations on hospital bed capacity decisions. The regulations are intended to decrease hospital investments without diminishing patient access. I find that the regulation decreases total hospital investment in bed capacity as expected. When running simulations to estimate how hospitals would behave differently were the regulatory policy changed, I find that total patient utility is negatively affected by the presence of the regulation as many patients get turned away from their preferred hospital due to overcrowding. This analysis has important policy implications as it suggests that the regulation has been ineffective in ensuring that patient welfare was unharmed by the restrictions.</p><p>The third chapter is based on joint research with Patrick Bayer and James W. Roberts and studies the housing market in the Los Angeles metropolitan area from 1988 to 2009. Using novel data, I identify which housing transactions involve flippers who aim not to live in the house, but rather to quickly resell it for financial gain. I find that flipper behavior varies based on how frequently I observe the individual engage in such behavior. Experienced flippers, who are observed to flip many houses in the data, target homes being sold at below market value and earn their returns from buying them at a discount. Their effect on long term prices in the neighborhood is negligable. Inexperienced flippers who are less active, seek to earn their profits by timing the market and are more active when house prices were rapidly appreciating from 1999 to 2005. Their activity increases housing prices in the neighborhood in the short term, but decreases them in the long term. Such results are consistent with the claim that real estate flipping contributed to the housing bubble.</p><p>The fourth chapter of my dissertation again focuses on the hospital industry and looks at the question of how patient composition changes as a hospital becomes busier and has to turn patients away. I develop a theoretical model which predicts that hospitals are more likely to turn away less profitable patients. As a result, when a hospital becomes more full and therefore is more likely to have to turn patients away, its composition of patients will change and become more profitable on the whole. I test this theory by empirically analyzing the effect of hospital congestion on the composition of hospital patients using hospital discharge data. The findings are consistent with my theoretical model as when hospitals become more crowded, the fraction of uninsured patients and mental health patients (who are typically not profitable to a hospital) decreases. This result suggests that hospitals are more likely to turn away unprofitable patients while continuing to admit more profitable patients.</p> / Dissertation
| Identifer | oai:union.ndltd.org:DUKE/oai:dukespace.lib.duke.edu:10161/7272 |
| Date | January 2013 |
| Creators | Geissler, Christopher Scott |
| Contributors | Sweeting, Andrew T |
| Source Sets | Duke University |
| Detected Language | English |
| Type | Dissertation |
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