Do Hospital Mergers Reduce Waiting Times? Theory and Evidence from the English NHS

52 Pages Posted: 11 Jul 2023

See all articles by Vanessa Cirulli

Vanessa Cirulli

Italian Agency for Development Cooperation

Giorgia Marini

University of Rome La Sapienza

Marco A. Marini

Marco A. Marini; University of Rome La Sapienza

Odd Rune Straume

CESifo (Center for Economic Studies and Ifo Institute); University of Minho - Economic Policies Research Unit (NIPE)

Date Written: July 4, 2023

Abstract

We analyse – theoretically and empirically – the effect of hospital mergers on waiting times in healthcare markets where prices are fixed. Using a spatial modelling framework where patients choose provider based on travelling distance and waiting times, we show that the effect is theoretically ambiguous. In the presence of cost synergies, the scope for lower waiting times as a result of the merger is larger if the hospitals are more profit-oriented. This result is arguably confirmed by our empirical analysis, which is based on a conditional flexible difference-indifferences methodology applied to a long panel of data on hospital mergers in the English NHS, where we find that the effects of a merger on waiting times crucially rely on a legal status that can reasonably be linked to the degree of profit-orientation. Whereas hospital mergers involving Foundation Trusts tend to reduce waiting times, the corresponding effect of mergers involving hospitals without this legal status tends to go in the opposite direction.

Note:
Funding Information: V. Cirulli, G. Marini and M. A. Marini acknowledge Önancial support from Sapienza University of Rome within the project RM12117A8AF18CC3 and from Edgard Milhaud Foundation, LiËge. O. R. Straume acknowl- edges Önancial support from National Funds of the FCT ñ Portuguese Foundation for Science and Technology within the project UIDB/03182/2020.

Conflict of Interests: I declare that there is no competing interest nor conflict of interest for none of the paper authors.

Keywords: Hospital merger, waiting times, profit-orientation

JEL Classification: I11, I18, L21, L41

Suggested Citation

Cirulli, Vanessa and Marini, Giorgia and Marini, Marco A. and Straume, Odd Rune and Straume, Odd Rune, Do Hospital Mergers Reduce Waiting Times? Theory and Evidence from the English NHS (July 4, 2023). FEEM Working Paper No. 14, Available at SSRN: https://ssrn.com/abstract=4500999 or http://dx.doi.org/10.2139/ssrn.4500999

Vanessa Cirulli

Italian Agency for Development Cooperation ( email )

Giorgia Marini

University of Rome La Sapienza ( email )

Piazzale Aldo Moro 5
Roma, Rome 00185
Italy

Marco A. Marini (Contact Author)

Marco A. Marini ( email )

Piazzale Aldo Moro, 5
Roma, 00185
Italy

HOME PAGE: http://sites.google.com/a/uniroma1.it/marcomarini/

University of Rome La Sapienza ( email )

29
Roma, 00185
Italy
+39 06 49910843 (Phone)

HOME PAGE: http://sites.google.com/a/uniroma1.it/marcomarini

Odd Rune Straume

CESifo (Center for Economic Studies and Ifo Institute)

Poschinger Str. 5
Munich, DE-81679
Germany

University of Minho - Economic Policies Research Unit (NIPE) ( email )

Campus de Gualtar
Braga, 4710-057
Portugal

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