The health care industry has been influenced by changes in the market structure and new technological developments during the recent decades. With the new technological developments in medicine, some less complex care moved out of the hospitals that led to decrease in demand for inpatient services. This recent change in hospital care created excess capacity in hospital markets, and therefore hospitals started to explore potential financial gains through horizontal consolidations. This has resulted in a wave of mergers in 1990s, which transformed the US, Canadian and European hospital markets. This, in turn, created concerns among policy makers and researchers in terms of its welfare implications.

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