EconPapers    
Economics at your fingertips  
 

Death by Market Power. Reform, Competition and Patient Outcomes in the National Health Service

Martin Gaynor (), Rodrigo Moreno-Serra () and Carol Propper

The Centre for Market and Public Organisation from Department of Economics, University of Bristol, UK

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 160 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.

Keywords: competition; hospitals; quality (search for similar items in EconPapers)
JEL-codes: I18 I11 L13 L32 (search for similar items in EconPapers)
New Economics Papers: this item is included in nep-com, nep-hea and nep-reg
Date: 2010-07
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (17) Track citations by RSS feed

Downloads: (external link)
http://www.bristol.ac.uk/cmpo/publications/papers/2010/wp242.pdf (application/pdf)

Related works:
Journal Article: Death by Market Power: Reform, Competition, and Patient Outcomes in the National Health Service (2013) Downloads
Working Paper: Death by Market Power: Reform, Competition and Patient Outcomes in the National Health Service (2011) Downloads
Working Paper: Death by Market Power: Reform, Competition and Patient Outcomes in the National Health Service (2010) Downloads
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:bri:cmpowp:10/242

Access Statistics for this paper

More papers in The Centre for Market and Public Organisation from Department of Economics, University of Bristol, UK Contact information at EDIRC.
Bibliographic data for series maintained by ().

 
Page updated 2019-09-20
Handle: RePEc:bri:cmpowp:10/242