Effects of Competition on Infertility Treatment Outcomes.pptVIP

Effects of Competition on Infertility Treatment Outcomes Melinda Henne Research In Progress Seminar Stanford University June 1, 2005 Research In Progress Results are preliminary Please do not cite or reference Acknowledgements Kate Bundorf Laurence Baker Jia Chan Shannon McConnville Outline Multiple Births and ART overview Literature on Competition Model Definition of Market Measure of Competition Equations Results Conclusions Outline Multiple Births and ART overview Literature on Competition Model Definition of Market Measure of Competition Equations Results Conclusions Trends in multiple birth rates Increasing utilization of ART in the U.S. Trends in ART Birth Rates ART Cycle Number of ART Clinics in United States Fertility Inc.: Clinics Race to Lure Clients “Infertility has become a big, fiercely competitive business, with a billion dollars in revenues and with more and more doctors fighting for a limited number of patients. The growth of the field has been fueled by rising success rates and increased demand from patients . . .” “critics say, they may implant too many embryos . . .” “Since most patients pay with their own money . . .fertility specialists say that if they want to survive, they have to get the attention of both patients and referring doctors” Outline Multiple Births and ART overview Literature on Competition Model Definition of Market Measure of Competition Equations Results Conclusions Competition in Healthcare Hospital Based Emergent or Urgent Care Mortality after AMI Mortality from Pneumonia Effects Lower costs, increased quality, decreased mortality, improved efficiency Excess capacity, higher costs, worse outcomes Steiner Cross sectional analysis, 2000 Competition Area Metropolitan Statistical Area or County Competition (low {1-2}, intermediate {2-7}, high{7}) Demand (low {130,000}, intermediate {130,000-600,000}, high {600,000}) Conclusion As competition increased, the percentage of high-order multiple pregnancies decreased Hamilton an