Does Competition between Hospitals Improve the Quality of Care? Hospital Death Rates and the NHS Internal Market
نویسندگان
چکیده
Payer-driven competition has been widely advocated as a means of increasing efficiency in health care markets. The 1990s reforms to the UK health service followed this path. We examine whether competition led to better outcomes for patients, as measured by death rates after treatment following heart attacks. Using data that until 1999 was not publicly available in any form on hospital level death rates, we find that the relationship between competition and quality of care appears to be negative. Greater competition is associated with higher death rates, controlling for patient mix and other observed characteristics of the hospital and the catchment area for its patients. However, the estimated impact of competition is small. JEL Classification: I1, L8, H4
منابع مشابه
Does competition between hospitals improve clinical quality? A review of evidence from two eras of competition in the English NHS.
The health secretary, Andrew Lansley, has proposed changes to the English National Health Service (NHS) that will extend the hospital market introduced by “New Labour” in the 2000s. 2 This was the second era of hospital competition within the NHS; the first, the “internal market,” applied throughout the UK from 1991 to 1997. Studies of the NHS markets have generally used one of two paradigms, e...
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