Market structure, patient choice and hospital quality for elective patients

Giuseppe Moscelli, Hugh Gravelle and Luigi Siciliani

No 139cherp, Working Papers from Centre for Health Economics, University of York

Abstract: We examine the change in the effect of market structure on hospital quality for elective procedures (hip and knee replacements, and coronary artery bypass grafts) following the 2006 loosening of restrictions on patient choice of hospital in England. We allow for time-varying endogeneity due to the effect of unobserved patient characteristics on patient choice of hospital using Two Stage Residual Inclusion. We find that the change in the effect of market structure due to the 2006 choice reforms was to reduce quality by increasing the probability of a post-operative emergency readmission for hip and knee replacement patients. There was no effect of the choice reform on hospital quality for coronary bypass patients. We find no evidence of self-selection of patients into hospitals, suggesting that a rich set of patient-level covariates controls for differences in casemix.

Keywords: competition; quality; hospital; choice; electives. (search for similar items in EconPapers)
JEL-codes: H51 I11 I18 L32 L33 (search for similar items in EconPapers)
Pages: 33 pages
Date: 2016-11
New Economics Papers: this item is included in nep-com, nep-eur, nep-hea and nep-ind
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (14)

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Persistent link: https://EconPapers.repec.org/RePEc:chy:respap:139cherp

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