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The Effects of Competition on Variation in Quality and Cost of Medical Care
National Bureau of Economic Research [NBER] 
Apr. 7, 2005
Excerpt: [The authors] estimate the effects of hospital competition on the level of and the variation in quality of care and hospital expenditures for elderly Medicare beneficiaries with heart attack. [The authors] compare competition's effects on more-severely ill patients, whom we assume value quality more highly, to the effects on less-severely ill, low-valuation patients.
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