Management

should be stringent when assessing proposed hospital mergers.Unfortunately, there is reason for concern on this issue since earlierNMa rulings show that the competition authority underestimatesthe adverse effects of hospital mergers on competition. Importantexamples in this context are the permitted hospital mergers betweenZiekenhuis Hilversum and Ziekenhuis Gooi Noord (2005), MC Alkmaarand Gemini Ziekenhuis (2007), and Ziekenhuis Walcheren andOosterscheldeziekenhuizen (2009).A more stringent assessment of hospital mergers is urgently needed,including a more accurate definition of relevant geographic hospitalmarkets. For this purpose, iBMG is analysing in detail why somepatients are willing to travel to hospitals farther away while othersare not. The innovative, empirical research on patients’ hospital choicebehaviour will provide a better insight into hospital substitutabilitythat underlies hospital competition. This research does not only resultin scientific publications in international peer-reviewed journals. It alsoleads to national publications, including policy recommendations,aimed at improving hospital merger control in the Netherlands.merger control“To guarantee sufficient freedom of choice, hospitalmergers in the Netherlands should be assessed morestringently. Research of iBMG on patients’ hospitalchoice behaviour and their willingness to travel isparticularly useful in this context.”Marco Varkevisser, PhD15