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Competition and Quality: Evidence from the NHS Internal Market 1991-9

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Author Info
Burgess, Simon
Gossage, Denise
Propper, Carol

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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.

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Paper provided by C.E.P.R. Discussion Papers in its series CEPR Discussion Papers with number 4026.

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Date of creation: Aug 2003
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Handle: RePEc:cpr:ceprdp:4026

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Related research
Keywords: competition; healthcare; mortality; quality of care;

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Find related papers by JEL classification:
H40 - Public Economics - - Publicly Provided Goods - - - General
I10 - Health, Education, and Welfare - - Health - - - General
L80 - Industrial Organization - - Industry Studies: Services - - - General

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  1. Dranove, David & White, William D, 1994. "Recent Theory and Evidence on Competition in Hospital Markets," Journal of Economics & Management Strategy, Blackwell Publishing, vol. 3(1), pages 169-209, Spring.
  2. Propper, Carol & Burgess, Simon & Green, Katherine, 2004. "Does competition between hospitals improve the quality of care?: Hospital death rates and the NHS internal market," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1247-1272, July. [Downloadable!] (restricted)
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This page was last updated on 2009-12-21.


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