An article of possible interest:
"Death by Market Power: Reform, Competition and Patient Outcomes
in the National Health Service"
CEPR Discussion Paper No. DP8203
Contact: MARTIN S. GAYNOR
Carnegie Mellon University, National Bureau of
Economic Research (NBER), Leverhulme Centre for
Market and Public Organisation
Email: [log in to unmask]
Auth-Page: http://ssrn.com/author=66276
Co-Author: RODRIGO MORENO-SERRA
Imperial College London
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Auth-Page: http://ssrn.com/author=1608686
Co-Author: CAROL PROPPER
University of Bristol - Leverhulme Centre for
Market and Public Organisation (CMPO), University
of Bristol - Department of Economics, Centre for
Economic Policy Research (CEPR)
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Auth-Page: http://ssrn.com/author=139302
Full Text: http://ssrn.com/abstract=1749844
ABSTRACT: 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 160
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.
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