Date of Award


Document Type


Degree Name

Master of Arts (MA)



First Advisor

Jessica Van Parys

Second Advisor

Partha Deb

Academic Program Adviser

Randall Filer


Recent increases in physician-hospital (i.e., vertical) integration has spurred both opposition on the grounds of anti-trust concerns and support on the basis of lowering transaction costs and improving communication. This paper examines the effects of vertical integration on quality of care as measured by malpractice claims.The study employs four data sets from the state of Florida (FL AHCA Financial Data, AHA Survey Data, FL AHCA Discharge Data, and FL Malpractice Claims from the Office of Insurance Regulation) culminating in an unbalanced panel dataset for the years 1998 to 2013. I utilize a linear model with hospital and year fixed effects as a well as a negative binomial model with hospital and year fixed effects. I find that vertically integrated hospitals have 7% fewer claims per year as compared to hospitals that are not vertically integrated. In addition, vertically integrated hospitals see a decline of about $522,000 in costs associated with malpractice claims per year. These results provide support for previous literature that finds vertical integration improves communication among health care providers, thereby avoiding events that lead to malpractice suits. In addition, these results indicate that vertical integration stands to benefit both patients (through fewer claims and improved quality of care) as well as hospitals (through a decline in claims and costs).



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.