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

• 成果类型: Article
• 署名作者: Gaynor, Martin; Moreno-Serra, Rodrigo; Propper, Carol
• 署名单位: Carnegie Mellon University; University of Bristol; National Bureau of Economic Research; Imperial College London; Imperial College London; Center for Economic & Policy Research (CEPR); Imperial College London
• 刊物名称: AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY
• ISSN/ISSBN: 1945-7731
• DOI: 10.1257/pol.5.4.134
• 发表日期: 2013
• 页码: 134-166
• 关键词: schools benefit students; public-schools; care; QUALITY; nhs; england; payment; CHOICE; Hospitals; PRIVATE

摘要

The effect of competition on the quality of health care remains a contested issue. Most empirical estimates rely on inference from nonexperimental 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. 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. We find that the effect of competition is to save lives without raising costs.