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Competition and Quality: Evidence from the NHS Internal Market 1991-9Simon M. BurgessUniversity 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 GossageUniversity of Bristol - Leverhulme Centre for Market and Public Organisation (CMPO) Carol PropperUniversity 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 seriesDate posted: October 10, 2003Suggested CitationContact Information
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