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Rice University

1. Xu, Yingying. Entry of Freestanding Emergency Departments in Texas – A series of Economic Studies.

Degree: PhD, Economics, 2019, Rice University

This 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. Advisors/Committee Members: Ho, Vivian (advisor).

Subjects/Keywords: Market Competition; Firm Entry; Healthcare Policy

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APA (6th Edition):

Xu, Y. (2019). Entry of Freestanding Emergency Departments in Texas – A series of Economic Studies. (Doctoral Dissertation). Rice University. Retrieved from http://hdl.handle.net/1911/106164

Chicago Manual of Style (16th Edition):

Xu, Yingying. “Entry of Freestanding Emergency Departments in Texas – A series of Economic Studies.” 2019. Doctoral Dissertation, Rice University. Accessed August 24, 2019. http://hdl.handle.net/1911/106164.

MLA Handbook (7th Edition):

Xu, Yingying. “Entry of Freestanding Emergency Departments in Texas – A series of Economic Studies.” 2019. Web. 24 Aug 2019.

Vancouver:

Xu Y. Entry of Freestanding Emergency Departments in Texas – A series of Economic Studies. [Internet] [Doctoral dissertation]. Rice University; 2019. [cited 2019 Aug 24]. Available from: http://hdl.handle.net/1911/106164.

Council of Science Editors:

Xu Y. Entry of Freestanding Emergency Departments in Texas – A series of Economic Studies. [Doctoral Dissertation]. Rice University; 2019. Available from: http://hdl.handle.net/1911/106164

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