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Death by market power : reform, competition and patient outcomes in the National Health Service

Author: Martin Gaynor; Rodrigo Moreno-Serra; Carol Propper; National Bureau of Economic Research.
Publisher: Cambridge, Mass. : National Bureau of Economic Research, ©2010.
Series: Working paper series (National Bureau of Economic Research), no. 16164.
Edition/Format:   eBook : Document : EnglishView all editions and formats
Summary:
The effect of competition on the quality of health care remains a contested issue. Most empirical estimates rely on inference from non experimental data. In contrast, this paper exploits a pro-competitive policy reform to provide estimates of the impact of competition on hospital outcomes. The English government introduced a policy in 2006 to promote competition between hospitals. Patients were given choice of  Read more...
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Material Type: Document, Internet resource
Document Type: Internet Resource, Computer File
All Authors / Contributors: Martin Gaynor; Rodrigo Moreno-Serra; Carol Propper; National Bureau of Economic Research.
OCLC Number: 648731633
Description: 1 online resource (53 pages) : illustrations, maps.
Series Title: Working paper series (National Bureau of Economic Research), no. 16164.
Responsibility: Martin Gaynor, Rodrigo Moreno-Serra, Carol Propper.

Abstract:

The effect of competition on the quality of health care remains a contested issue. Most empirical estimates rely on inference from non experimental data. In contrast, this paper exploits a pro-competitive policy reform to provide estimates of the impact of competition on hospital outcomes. The English government introduced a policy in 2006 to promote competition between hospitals. Patients were given choice of location for hospital care and provided information on the quality and timeliness of care. Prices, previously negotiated between buyer and seller, were set centrally under a DRG type system. Using this policy to implement a difference-in-differences research design we estimate the impact of the introduction of competition on not only clinical outcomes but also productivity and expenditure. Our data set is large, containing information on approximately 68,000 discharges per year per hospital from 162 hospitals. We find that the effect of competition is to save lives without raising costs. Patients discharged from hospitals located in markets where competition was more feasible were less likely to die, had shorter length of stay and were treated at the same cost.

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