Effects of market structure and patient choice on hospital quality for planned patients

Giuseppe Moscelli, Hugh Gravelle and Luigi Siciliani

No 162cherp, Working Papers from Centre for Health Economics, University of York

Abstract: We investigate the change in the effect of market structure on planned hospital quality for three high-volume treatments, using a quasi difference in differences approach based on the relaxation of patient constraints on hospital choice in England. We employ control functions to allow for timevarying endogeneity from unobserved patient characteristics. We find that the choice reforms reduced quality for hip and knee replacement but not for coronary bypass. This is likely due to hospitals making a larger loss on hip and knee replacements, since robustness checks rule out changes in length of stay, new competitors’ entry and hospital-level mortality as possible confounders.

Keywords: competition; quality; hospital; choice; endogeneity; difference in difference; control function. (search for similar items in EconPapers)
JEL-codes: H51 I11 I18 L32 L33 (search for similar items in EconPapers)
Pages: 56 pages
Date: 2019-03
New Economics Papers: this item is included in nep-com, nep-eur and nep-hea
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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https://www.york.ac.uk/media/che/documents/papers/ ... hospital_quality.pdf First version, 2019 (application/pdf)

Related works:
Working Paper: Effects of Market Structure and Patient Choice on Hospital Quality for Planned Patients (2018)
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Persistent link: https://EconPapers.repec.org/RePEc:chy:respap:162cherp

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