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Objectives To assess the issue of hospital variations in Colombia and to contribute to the methodology on health care variations by using a model that clusters the variance between hospitals while accounting for individual-level reimbursement rates and objective health-status variables. Methods We used data on all births (N = 11,954) taking place in a contributory-regimen insurer network in Colombia during 2007. A multilevel logistic regression model was used to account for the share of unexplained variance between hospitals. In addition, an alternative variance decomposition specification was further carried out to measure the proportion of such unexplained variance due to the region effect. Results Hospitals account for 20% of the variation in performing cesarean sections, whereas region explains only one-third of such variance. Variables accounting for preferences on the demand side as well as reimbursement rates are found to predict the probability of performing cesarean sections. Conclusions Hospital variations explain large variances within a single-payer’s network. Because this insurer company is highly regarded in terms of performance and finance, these results might provide a lower bound for the scale of hospital variation in the Colombian health care market. Such lower bound provides guidance on the relevance of this issue for Colombia. Some factors such as demand-side preferences and physician reimbursement rates increase variations in health care even within a single-payer network. This is a source of inefficiencies, threatening the quality of health care and financial sustainability. The proposed methodology should be considered in further research on health care variations. [ABSTRACT FROM AUTHOR]

This study examines how the level of concentration of a country's mobile telecommunications market affects its competitiveness. We created a unique database with information on 59 countries, which we used to perform several estimations including an instrumental variable approach to explain the degree of concentration in mobile phone markets. Our first and direct estimation shows that the higher the concentration in this industry, the lower the countries' competitiveness. In order to understand this positive correlation, we provide two additional estimations. First, using an instrumental variable, we find that the concentration in mobile telecommunications market explains the use of information and communications technology (ICT). Moreover, we also find that the use of ICT is positively correlated with countries' competitiveness. Thus, our results confirm that the mobile phone industry has positive spillover effects on countries' competitiveness and demonstrate the benefits of policies designed to reduce concentration and market power in the industry. • We measure the impact of the concentration in the mobile market on countries' competitiveness. • Our results indicate that a higher concentration in the mobile phone industry is related to a lower level of competitiveness. • A higher degree of concentration in the mobile phone markets causes, on average, a reduction of 0.45 points (it is a scale of 1 to 7) at the level of digitisation of the countries' economies. • We also find that on average, higher levels of digitization correlate positively with higher competitiveness. • Our results suggest that regulations that aim to promote competition in mobile phone markets may generate positive externalities on other sectors of the economy. [ABSTRACT FROM AUTHOR]