Does hospital competition harm equity? Evidence from the English National Health Service

Richard Cookson, Mauro Laudicella and Paolo Li Donni ()
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Richard Cookson: Centre for Health Economics, University of York, UK

No 066cherp, Working Papers from Centre for Health Economics, University of York

Abstract: Increasing evidence shows that hospital competition under fixed prices can improve quality and reduce cost. Concerns remain, however, that competition may undermine socio-economic equity in the utilisation of care. We test this hypothesis in the context of the pro-competition reforms of the English National Health Service progressively introduced from 2004 to 2006. We use a panel of 32,482 English small areas followed from 2003 to 2008 and a difference in differences approach. The effect of competition on equity is identified by the interaction between market structure, small area income deprivation and year. We find a negative association between market dispersion and elective admissions in deprived areas. The effect of pro-competition reform was to reduce this negative association slightly, suggesting that competition did not undermine equity.

Pages: 30 pages
Date: 2011-10
New Economics Papers: this item is included in nep-com and nep-hea
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Citations: View citations in EconPapers (4)

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http://www.york.ac.uk/media/che/documents/papers/r ... tion_harm_equity.pdf First version, 2011 (application/pdf)

Related works:
Journal Article: Does hospital competition harm equity? Evidence from the English National Health Service (2013)
Working Paper: Does hospital competition harm equity? Evidence from the English National Health Service (2013)
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Persistent link: https://EconPapers.repec.org/RePEc:chy:respap:66cherp

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