Sub-lognormal size distribution of hospitals — An agent-based approach and empirical study

This paper studies the size distribution of hospitals and its underlying generative mechanisms. Based on the U.S. hospital data, we find that the size distribution is sub-lognormal (a leptokurtic distribution more skewed than normal but less skewed than lognormal). This distribution is different from those of firms and cities. We develop an agent-based simulation model to simulate the preference behavior of patients and the service processes of hospitals. The model can produce a sub-lognormal size distribution similar to the U.S. hospital size distribution. Sensitivity analysis shows that the patients´ preference behavior and search distance are two key factors for the emergence of the sub-lognormal size distribution.