Hospital competition and quality for non‐emergency patients in the English NHS.

We investigate the effect on the quality of three high‐volume non‐emergency treatments of a reform that relaxed restrictions on patient choice of hospital. We employ a quasi difference‐in‐difference strategy and use control functions allowing for patient selection into providers correlated with unob...

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Published in:RAND Journal of Economics (Wiley-Blackwell) Vol. 52; no. 2; pp. 382 - 415
Main Authors: Moscelli, Giuseppe, Gravelle, Hugh, Siciliani, Luigi
Format: Article
Published: Wiley-Blackwell Jun2021
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Jun2021
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        atl: Hospital competition and quality for non‐emergency patients in the English NHS.
      aug:
        au:
          Moscelli, Giuseppe
          Gravelle, Hugh
          Siciliani, Luigi
        affil:
          Economics of Social and Health Care Research Unit, Centre for Health Economics
          School of Economics, University of Surrey
          Department of Economics and Related Studies, University of York
      su:
        Great Britain. National Health Service
        Coronary artery bypass
        Public hospitals
        Total hip replacement
        Patient selection
        Emergency physicians
      sug:
        subj:
          Great Britain. National Health Service
          General Medical and Surgical Hospitals
          Coronary artery bypass
          Public hospitals
          Total hip replacement
          Patient selection
          Emergency physicians
      keyword:
        choice
        competition
        control function
        difference‐in‐difference
        hospital
        quality
        choice
        competition
        control function
        difference‐in‐difference
        hospital
        quality
      ab: We investigate the effect on the quality of three high‐volume non‐emergency treatments of a reform that relaxed restrictions on patient choice of hospital. We employ a quasi difference‐in‐difference strategy and use control functions allowing for patient selection into providers correlated with unobserved morbidity. Public hospitals facing more rivals reduced quality, increased waiting times, and reduced length of stay for hip and knee replacements. This is likely due to regulated prices implying larger losses on these treatments compared to coronary artery bypass grafts, where no effects were found. Our findings are robust to estimation methods and competition measures, allowing for private providers' entry.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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