Hospital competition, service provision and quality: Evidence from maternity units

Yasemin Karamik and Simon Reif

No 25-025, ZEW Discussion Papers from ZEW - Leibniz Centre for European Economic Research

Abstract: Maternity unit closures are increasingly common in areas with low birth rates, resulting in diminished competition between units. We examine how competition affects the quality and amenities of the remaining maternity units in Germany. To address potential endogeneity in the level of competition, we exploit the unpopularity of maternity unit closures and instrument competition with the tightness of past regional elections. Our findings indicate that while low competition does not significantly affect the quality of care, it leads to reduced availability of additional services potentially used to attract patients in the higher competitive market.

Keywords: Maternity unis; hospital competition; healthcare quality; non-price amenities (search for similar items in EconPapers)
JEL-codes: I11 I18 L13 (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:zbw:zewdip:319895

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