Hospital competition and quality for non-emergency patients in the English NHS

• 成果类型: Article
• 署名作者: Moscelli, Giuseppe; Gravelle, Hugh; Siciliani, Luigi
• 署名单位: University of York - UK; University of Surrey; University of York - UK
• 刊物名称: RAND JOURNAL OF ECONOMICS
• ISSN/ISSBN: 0741-6261
• DOI: 10.1111/1756-2171.12373
• 发表日期: 2021
• 页码: 382-414
• 关键词: of-care; CHOICE; performance; practitioners; econometrics; readmissions; endogeneity; association; difference; inference

摘要

We investigate the effect on the quality of three high-volume non-emergency treatments of a reform that relaxed restrictions on patient choice of hospital. We employ a quasi difference-in-difference strategy and use control functions allowing for patient selection into providers correlated with unobserved morbidity. Public hospitals facing more rivals reduced quality, increased waiting times, and reduced length of stay for hip and knee replacements. This is likely due to regulated prices implying larger losses on these treatments compared to coronary artery bypass grafts, where no effects were found. Our findings are robust to estimation methods and competition measures, allowing for private providers' entry.