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The effect of competition on process and outcome quality of hospital care: An empirical analysis for the Netherlands

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  • Michiel Bijlsma

    ()

  • Pierre Koning

    ()

  • Victoria Shestalova

    ()

  • Ali Aouragh

    ()

Abstract

The paper focuses on the relationship between competition and quality in the Dutch hospital sector. We analyse the period of 2004-2008, in which a healthcare reform took place in the Netherlands, introducing competition in the healthcare sector. The increased attention to hospital quality and its growing importance in a new institutional environment have resulted in a gradual increase of the voluntary disclosure of quality indicators by Dutch hospitals. We use panel data on Dutch general and academic hospitals in 2004-2008, including both process indicators (e.g., share of operation cancellations on short notice and share of diagnoses within 5 days) and outcome indicators (e.g., mortality rates) of hospital quality. We take the correlation between the disclosure decision and the level of the disclosed quality indicators explicitly into account by estimating a bivariate model. We find that competition explains differences in performance on process indicators, but not on outcome indicators.

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Bibliographic Info

Paper provided by CPB Netherlands Bureau for Economic Policy Analysis in its series CPB Discussion Paper with number 157.

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Date of creation: Sep 2010
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Handle: RePEc:cpb:discus:157

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  1. Nicholas Bloom & Carol Propper & Stephan Seiler & John van Reenan, 2010. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," The Centre for Market and Public Organisation 10/237, Department of Economics, University of Bristol, UK.
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