Economies of Scale and Scope in Hospitals: An Empirical Study of Volume Spillovers

General hospitals across the world are becoming larger (i.e., admitting more patients each year) and complex offering a wider range of services to with diverse care needs). Prior work suggests that an increase in patient volume hospital service is associated reduced costs per service. However, it unclear how changes one affect other same hospital. This paper investigates such volume-cost spillover effects between elective emergency admissions specialties, using condition-level panel data comprising all acute trusts England over period 10 years. We provide evidence increased at cost (a negative spillover). Furthermore, for admissions, we find activity specialty lower specialties positive By contrast, no admissions. discuss implications these findings individual growth strategies regional organization systems. was accepted by David Simchi-Levi, operations management.