The Effect of Freedom of Choice on Health System Responsiveness. Evidence from Spain

Fernández-Pérez, A.;, Jiménez-Rubio, D.; and Robone, S.;

Health, Econometrics and Data Group (HEDG) Working Papers from HEDG, c/o Department of Economics, University of York

Abstract: Public policies fostering the freedom of choice in the healthcare sector are becoming increasingly usual in Europe in order to boost patient empowerment and improving health system responsiveness. However, there is limited evidence regarding the effects of freedom of choice policies. The goal of this study is to contribute to this literature by analysing the impact of the implementation of the Single Health Area in the Spanish region of Madrid in 2009. This reform allowed citizens to freely choose among any General Practitioner and Specialist of any health centre of the region. We focus on studying the effect on the health services responsiveness -as defined by the World Health Organization - drawing on cross-section microdata from the Spanish Healthcare Barometer for 2002-2016 and making use of the synthetic control estimation techniques. The findings show that the reform caused a strong positive impact on the Prompt Attention domain in specialised care. By contrast, the reform caused a drop in the responsiveness with Communication and Dignity domains in primary care. The results of this paper could provide policy-makers with empirical evidence about the impact of the freedom of choice policies on the quality of care provided by the health services.

Keywords: health system responsiveness; synthetic control method; freedom of choice (search for similar items in EconPapers)
Date: 2019-10
New Economics Papers: this item is included in nep-hea
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