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. 2011 Aug;121(554):F228-F260.
doi: 10.1111/j.1468-0297.2011.02449.x.

Does Hospital Competition Save Lives? Evidence from the English NHS Patient Choice Reforms

Zack Cooper  1 , Stephen Gibbons  1 , Simon Jones  1 , Alistair McGuire  1
Affiliations

Does Hospital Competition Save Lives? Evidence from the English NHS Patient Choice Reforms

Zack Cooper et al. Econ J (London). 2011 Aug.

Abstract

Recent substantive reforms to the English National Health Service expanded patient choice and encouraged hospitals to compete within a market with fixed prices. This study investigates whether these reforms led to improvements in hospital quality. We use a difference-in-difference-style estimator to test whether hospital quality (measured using mortality from acute myocardial infarction) improved more quickly in more competitive markets after these reforms came into force in 2006. We find that after the reforms were implemented, mortality fell (i.e. quality improved) for patients living in more competitive markets. Our results suggest that hospital competition can lead to improvements in hospital quality.

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Figures

Figure 1
Figure 1
Timeline for the Second Wave of NHS Market-based Reforms (2001–8)
Figure 2
Figure 2
Changes in Predicted Mortality Rates Over Time in Monopoly Markets with One-Site Providing Care and in Markets in the Most Competitive Decile of Our Market Structure Index
See this image and copyright information in PMC

References

    1. Allen F. Reputation and product quality. Rand Journal of Economics. 1984;15(3):311–27.
    1. Bloom N, Propper C, Seiler S, Van Reenan J. ‘The impact of competition on management quality: evidence from public hospitals’. London School of Economics; 2010. CEP Working Paper – February 14th.
    1. Bradley EH, Herrin J, Elbel B, McNamara RL, Magid DJ, Nallamothu BK, Wang Y, Normand SL, Spertus JA, Krumholz HM. Hospital quality for acute myocardial infarction: correlation among process measures and relationship with short-term mortality. JAMA. 2006;296(1):72–8. - PubMed
    1. Card D. Using regional variation in wages to measure the effects of the federal minimum wage. Industrial and Labor Relations Review. 1992;46(1):22–37.
    1. Charlson M, Pompei P, Ales K, MacKenzie C. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Disease. 1978;40(5):373–83. - PubMed