The Quality and Efficiency Between Public and Private Firms: Evidence from Ambulance Services
Daniel Knutsson () and
No 1365, Working Paper Series from Research Institute of Industrial Economics
Economic theory predicts that outsourcing public services to private firms will reduce costs, but the effect on quality is ambiguous. We explore quality differences between publicly and privately owned ambulances in a setting where patients are as good as randomly assigned to ambulances with different ownership statuses. We find that privately owned ambulances perform better in response to contracted quality measures but perform worse in response to noncontracted measures such as mortality. In fact, a randomly allocated patient has a 1.4% higher risk of death within 3 years if a private ambulance is dispatched (in aggregate, 420 more deaths each year). We also present evidence of the mechanism at work, suggesting that private firms cut costs at the expense of ambulance staff quality.
Keywords: Public outsourcing; Pre-hospital care; Healthcare quality; Health (search for similar items in EconPapers)
JEL-codes: D22 D44 H44 I11 L33 P48 (search for similar items in EconPapers)
Pages: 79 pages
Date: 2020-10-10, Revised 2021-07-01
New Economics Papers: this item is included in nep-eff, nep-hea, nep-ind and nep-lab
References: View references in EconPapers View complete reference list from CitEc
Citations: Track citations by RSS feed
Downloads: (external link)
https://www.ifn.se/wfiles/wp/wp1365.pdf Full text (application/pdf)
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
Persistent link: https://EconPapers.repec.org/RePEc:hhs:iuiwop:1365
Access Statistics for this paper
More papers in Working Paper Series from Research Institute of Industrial Economics Research Institute of Industrial Economics, Box 55665, SE-102 15 Stockholm, Sweden. Contact information at EDIRC.
Bibliographic data for series maintained by Elisabeth Gustafsson ().