The effect of competition on process and outcome quality of hospital care: An empirical analysis for the Netherlands
AbstractThe 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 InfoPaper provided by CPB Netherlands Bureau for Economic Policy Analysis in its series CPB Discussion Paper with number 157.
Date of creation: Sep 2010
Date of revision:
Find related papers by JEL classification:
- I1 - Health, Education, and Welfare - - Health
- L8 - Industrial Organization - - Industry Studies: Services
- H4 - Public Economics - - Publicly Provided Goods
This paper has been announced in the following NEP Reports:
- NEP-ALL-2010-10-02 (All new papers)
- NEP-COM-2010-10-02 (Industrial Competition)
- NEP-HEA-2010-10-02 (Health Economics)
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2010.
"The Impact of Competition on Management Quality: Evidence from Public Hospitals,"
NBER Working Papers
16032, National Bureau of Economic Research, Inc.
- Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2010. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," CEP Discussion Papers dp0983, Centre for Economic Performance, LSE.
- 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.
- Propper, C & Bloom, N & Seiler, S & Van Reenen, J, . "The impact of competition on management quality: evidence from public hospitals," Working Papers 5915, Imperial College, London, Imperial College Business School.
- Bloom, Nicholas & Propper, Carol & Seiler, Stephan & Van Reenen, John, 2010. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," CEPR Discussion Papers 7862, C.E.P.R. Discussion Papers.
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