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Competition and Quality: Evidence from the NHS Internal Market 1991-9


Simon M. Burgess


University of Bristol - Department of Economics; University of Bristol - Leverhulme Centre for Market and Public Organisation (CMPO); Centre for Economic Policy Research (CEPR); Institute for the Study of Labor (IZA)

Denise Gossage


University of Bristol - Leverhulme Centre for Market and Public Organisation (CMPO)

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)

August 2003

CEPR Discussion Paper No. 4026

Abstract:     
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. We exploit differences in competition over time and space to identify the impact of competition. Using data on mortality as a measure of hospital quality and exploiting the policy change during the 1990s, we find that the relationship between competition and quality of care appears to be negative.

Number of Pages in PDF File: 49

Keywords: Competition, mortality, quality of care, healthcare

JEL Classification: H40, I10, L80

working papers series


Date posted: October 10, 2003  

Suggested Citation

Burgess, Simon M., Gossage, Denise and Propper, Carol, Competition and Quality: Evidence from the NHS Internal Market 1991-9 (August 2003). CEPR Discussion Paper No. 4026. Available at SSRN: http://ssrn.com/abstract=457660

Contact Information

Simon Burgess (Contact Author)
University of Bristol - Department of Economics ( email )
8 Woodland Road
Bristol BS8 ITN
United Kingdom
+44 117 928 8436 (Phone)
+44 117 928 8577 (Fax)
HOME PAGE: http://www.bris.ac.uk/Depts/Economics/department/profiles/burgess.htm
University of Bristol - Leverhulme Centre for Market and Public Organisation (CMPO)
12 Priory Road
Bristol BS8 1TN
United Kingdom
Centre for Economic Policy Research (CEPR)
77 Bastwick Street
London, EC1V 3PZ
United Kingdom
Institute for the Study of Labor (IZA)
P.O. Box 7240
Bonn, D-53072
Germany
Denise Gossage
University of Bristol - Leverhulme Centre for Market and Public Organisation (CMPO) ( email )
12 Priory Road
Bristol BS8 1TN
United Kingdom
Carol Propper
University of Bristol - Leverhulme Centre for Market and Public Organisation (CMPO) ( email )
12 Priory Road
Bristol BS8 1TN
United Kingdom
HOME PAGE: http://www.bris.ac.uk/Depts/Economics/department/profiles/propper.htm
University of Bristol - Department of Economics ( email )
8 Woodland Road
Bristol BS8 ITN
United Kingdom
+44 117 928 8427 (Phone)
+44 117 954 6997 (Fax)
HOME PAGE: http://www.bris.ac.uk/Depts/Economics/department/profiles/propper.htm
Centre for Economic Policy Research (CEPR)
77 Bastwick Street
London, EC1V 3PZ
United Kingdom
Feedback to SSRN (Beta)


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