Death by Market Power: Reform, Competition and Patient Outcomes in the National Health Service

68 Pages Posted: 7 Jul 2011 Last revised: 9 Mar 2014

See all articles by Martin Gaynor

Martin Gaynor

Carnegie Mellon University; National Bureau of Economic Research (NBER); Leverhulme Centre for Market and Public Organisation

Carol Propper

Imperial College London Business School; Centre for Economic Policy Research (CEPR); University of Bristol - Leverhulme Centre for Market and Public Organisation (CMPO)

Rodrigo Moreno-Serra

Imperial College London

Multiple version iconThere are 3 versions of this paper

Date Written: June 1, 2010

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. 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. We find that the effect of competition is to save lives without raising costs.

Keywords: competition, hospitals, quality

JEL Classification: I18, I11, L13, L32

Suggested Citation

Gaynor, Martin and Propper, Carol and Moreno-Serra, Rodrigo, Death by Market Power: Reform, Competition and Patient Outcomes in the National Health Service (June 1, 2010). American Society of Health Economists (ASHEcon) Paper . Available at SSRN: https://ssrn.com/abstract=1880692 or http://dx.doi.org/10.2139/ssrn.1880692

Martin Gaynor (Contact Author)

Carnegie Mellon University ( email )

H. John Heinz III School of Public Policy
and Management
Pittsburgh, PA 15213-3890
United States
412-268-7933 (Phone)
412-268-5338 (Fax)

National Bureau of Economic Research (NBER)

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

Leverhulme Centre for Market and Public Organisation

12 Priory Road
Bristol BS8 1TN
United Kingdom

Carol Propper

Imperial College London Business School ( email )

South Kensington Campus
Exhibition Road
London SW7 2AZ, SW7 2AZ
United Kingdom

Centre for Economic Policy Research (CEPR)

London
United Kingdom

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

Rodrigo Moreno-Serra

Imperial College London ( email )

South Kensington Campus
Exhibition Road
London, Greater London SW7 2AZ
United Kingdom

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