Interesting. We have just published a paper on access issues re myocardial infarction. We are still working on this and hope to develop optimization models which were not considered in the published paper. Here's the link to the published work:
http://www.openmedicine.ca/article/view/302/298
For an entirely different problem -- sub-prime mortgages in the US 2005-2008 -- we used the H-H index as a measure of the changing competitiveness of that market. That paper has been accepted for E&P A and so is not yet available for distribution.
I'll take a look at the papers that Alison has mentioned and see if I can help.
Nigel Waters
PS Happy GIS Day!
----- Original Message -----
From: "Macfarlane, Alison" <[log in to unmask]>
Date: Wednesday, November 17, 2010 7:23 am
Subject: Re: Help urgently needed
> Can anyone help here, please? I have read the second of these two
> papers. They use econometric concepts and models, including the
> Herfindahl-Hirschmann concentration index, the Clarkson Index and
> the 'differences-in-differences' approach to modelling change.
>
> What I have noticed is that.
>
> 1. Elective surgery episodes, in which 'choice' will have
> been introduced have been used to classify hospitals, or is it
> trusts, but the analyses focus on acute myocardial infarction in
> which people go to the nearest A&E department.
>
> 2. When 'choice' was introduced, some people were made to
> 'choose' private hospitals with spare capacity or Intermediate
> sector treatment units, which did not submit data to HES, so may
> not have been included in this analysis.
>
> 3. There doesn't seem to be any allowance for selective
> transfer between hospitals once admitted.
>
> Alison
>
> From: Allyson Pollock [mailto:[log in to unmask]]
> Sent: 16 November 2010 18:09
> To: Macfarlane, Alison
> Cc: [log in to unmask] Kirkwood; Sylvia Godden
> Subject: Re: papers
>
>
> On the LSE website can download
>
>
>
> Zack Cooper, Stephen Gibbons, Simon Jones, Alistair McGuire. "Does
> Hospital Competition Save Lives? Evidence from the English NHS
> Patient Choice Reforms"
> LSE Health Working Paper No
> 16<http://www2.lse.ac.uk/LSEHealthAndSocialCare/LSEHealth/pdf/Workingpapers/WP16.pdf>. London.
>
> Zack Cooper, Julian Le Grand. "Unpacking the Relationship Between
> Patient Choice and Equity in Health Care".
>
>
> Also
>
>
> Death by Market Power: Reform, Competition and Patient Outcomes in
> the National Health Service | Martin Gaynor, Rodrigo Moreno-Serra,
> Carol PropperMartin Gaynor, Rodrigo Moreno-Serra, Carol Propper:
> NBER<http://jhpplnewsandnotes.wordpress.com/2010/07/16/death-by-
> market-power-reform-competition-and-patient-outcomes-in-the-
> national-health-service-martin-gaynor-rodrigo-moreno-serra-carol-
> proppermartin-gaynor-rodrigo-moreno-serra-carol-propper-n/>
>
> Martin Gaynor<http://papers.nber.org/authors/martin_gaynor>,
> Rodrigo Moreno-Serra<http://papers.nber.org/authors/rodrigo_moreno-
> serra>, Carol
> Propper<http://papers.nber.org/authors/carol_propper>. Death by
> Market Power: Reform, Competition and Patient Outcomes in the
> National Health Service. NBER Working Paper No. 16164, July 2010.
>
> The effect of competition on the quality of health care remains a
> contested issue. Most empirical estimates rely on inference from
> non experimental 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. Patients were given choice of location for hospital
> care and provided information on the quality and timeliness of
> care. Prices, previously negotiated between buyer and seller, were
> set centrally under a DRG type system. 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. Our data set is
> large, containing information on approximately 68,000 discharges
> per year per hospital from 162 hospitals. We find that the effect
> of competition is to save lives without raising costs. Patients
> discharged from hospitals located in markets where competition was
> more feasible were less likely to die, had shorter length of stay
> and were treated at the same cost. Source:
> NBER<http://papers.nber.org/papers/w16164>.
> This entry was posted on Friday, July 16th, 2010 at 10:09 PM and
> is filed under NN20-Articles-
> Papers<http://en.wordpress.com/tag/nn20-articles-papers/>. You can
> follow any responses to this entry through the RSS
> 2.0<http://jhpplnewsandnotes.wordpress.com/2010/07/16/death-by-
> market-power-reform-competition-and-patient-outcomes-in-the-
> national-health-service-martin-gaynor-rodrigo-moreno-serra-carol-
> proppermartin-gaynor-rodrigo-moreno-serra-carol-propper-n/feed/>
> feed. You can leave a
> response<http://jhpplnewsandnotes.wordpress.com/2010/07/16/death-by-market-power-reform-competition-and-patient-outcomes-in-the-national-health-service-martin-gaynor-rodrigo-moreno-serra-carol-proppermartin-gaynor-rodrigo-moreno-serra-carol-propper-n/#respond>, or trackback<http://jhpplnewsandnotes.wordpress.com/2010/07/16/death-by-market-power-reform-competition-and-patient-outcomes-in-the-national-health-service-martin-gaynor-rodrigo-moreno-serra-carol-proppermartin-gaynor-rodrigo-moreno-serra-carol-propper-n/trackback/> from your own site.
>
> On 16 Nov 2010, at 17:55, Macfarlane, Alison wrote:
>
>
> Dear all,
>
> Do you have the papers?
>
> Ali
>
> From: Allyson Pollock [mailto:[log in to unmask]]
> Sent: 16 November 2010 17:04
> To: [log in to unmask]<mailto:[log in to unmask]>
> Kirkwood; Macfarlane, Alison; Sylvia Godden
> Subject: papers
>
> From Independent and ow doing the rounds - can we take a look at
> urgently . Ali I dont understand the modelling - who can we ask?
>
>
> Indep on Sunday
> Once again, we know "what works". It is the Blair reforms. Brown
> tried to tone down some of the more market-sounding language
> because a lot of people don't like it, but he didn't really slow
> the momentum. Some recent academic research has produced dramatic,
> and under-reported, findings. A paper this summer by Martin
> Gaynor, Rodrigo Moreno-Serra and Carol Propper of Bristol
> University and Imperial College assessed the change in 2006 to
> give patients the right to choose their hospital: "The effect of
> competition is to save lives without raising costs. Patients
> discharged from hospitals located in markets where competition was
> more feasible were less likely to die, had shorter length of stay
> and were treated at the same cost." This was no one-off. A similar
> study by Zack Cooper and others at the LSE published in January
> came to the same stark conclusion that patients were more likely
> to die where there was a monopoly provider of NHS services
>
>
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