IDEAS home Printed from https://ideas.repec.org/a/bba/j00001/v4y2025i1p51-65d326.html
   My bibliography  Save this article

Competition in French hospital: Does it impact the patient management in healthcare?

Author

Listed:
  • Carine Milcent

    (Center for National Scientific Research (CNRS), Paris School of Economics, Paris, France)

Abstract

This research paper examines changes in patient care management in acute care hospitals between 2001 and 2011. During this time, there were two opposing factors at play: the competition effect of the reform and the policymaker’s decision to reduce public hospitals across France. By studying the trends, it is evident that there has been a significant overall shift in patient care management during this period. This change could be attributed to the global competition effect and the concentration of in-patients in specific public facilities. Through the difference-in-difference method, the study analyzed time variations in the intensity of local competition. It was found that local competition had a negligible impact on patient care management. Additionally, the study revealed that there was a significant positive competition effect on high-technical procedures for the private sector, which is in line with the market segment where private sector hospitals have a leadership position and the pro-competitive reform intensified this position. The study also uncovered a negative competition effect on the length of stay for public hospitals. Prior to the implementation of the DRG-based payment reform, public sector hospitals were paid a global budget. However, after the reform was implemented, they had to shorten the length of stay to increase the number of stays. For-profit hospitals have always been paid based on the number of stays. The results are robust and consistent when alternative measures of local competition are used.

Suggested Citation

  • Carine Milcent, 2025. "Competition in French hospital: Does it impact the patient management in healthcare?," Journal of Economic Analysis, Anser Press, vol. 4(1), pages 51-65, March.
    • Handle: RePEc:bba:j00001:v:4:y:2025:i:1:p:51-65:d:326
    as

    Download full text from publisher

    File URL: https://www.anserpress.org/journal/jea/4/1/89/pdf
    Download Restriction: no
    File URL: https://www.anserpress.org/journal/jea/4/1/89
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Ridder, Geert & Tunali, Insan, 1999. "Stratified partial likelihood estimation," Journal of Econometrics, Elsevier, vol. 92(2), pages 193-232, October.
    2. Moulton, Brent R, 1990. "An Illustration of a Pitfall in Estimating the Effects of Aggregate Variables on Micro Unit," The Review of Economics and Statistics, MIT Press, vol. 72(2), pages 334-338, May.
    3. Paolo Berta & Gianmaria Martini & Francesco Moscone & Giorgio Vittadini, 2016. "The association between asymmetric information, hospital competition and quality of healthcare: evidence from Italy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 907-926, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Carine Milcent, 2021. "Competition in French hospital: Does it impact the patient management in healthcare?," Working Papers halshs-03152752, HAL.
    2. Carine Milcent, 2021. "Competition in French hospital: Does it impact the patient management in healthcare?," Working Papers halshs-03152752, HAL.
    3. Carine Milcent, 0. "Competition in French hospital: Does it impact the patient management in healthcare?," Journal of Economic Analysis, Anser Press, vol. 0(1), pages 1-1.
    4. Ronald Bachmann & Sebastian Braun, 2011. "The Impact Of International Outsourcing On Labour Market Dynamics In Germany," Scottish Journal of Political Economy, Scottish Economic Society, vol. 58(1), pages 1-28, February.
    5. Laurent Gobillon & Carine Milcent, 2013. "Spatial disparities in hospital performance," Journal of Economic Geography, Oxford University Press, vol. 13(6), pages 1013-1040, November.
    6. Alois Stutzer & Rafael Lalive, 2002. "Soziale Arbeitsnorm und Arbeitslosigkeit in der Schweiz," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 138(III), pages 293-316, September.
    7. Roberto Bande Ramudo & Melchor Fernández Fernández & Víctor Montuenga Gómez, 2011. "Wage flexibility and local labour markets: homogeneity of the wage curve in Spain," Documentos de trabajo - Analise Economica 0044, IDEGA - Instituto Universitario de Estudios e Desenvolvemento de Galicia.
    8. Maria De Paola & Vincenzo Scoppa, 2010. "Peer group effects on the academic performance of Italian students," Applied Economics, Taylor & Francis Journals, vol. 42(17), pages 2203-2215.
    9. Salimata Sissoko, 2011. "Working Paper 03-11 - Niveau de décentralisation de la négociation et structure des salaires," Working Papers 1103, Federal Planning Bureau, Belgium.
    10. Stephen Drinkwater, 2003. "Go West? Assessing the willingness to move from Central and Eastern European Countries," School of Economics Discussion Papers 0503, School of Economics, University of Surrey.
    11. Manthos D. Delis & Sotirios Kokas & Steven Ongena, 2016. "Foreign Ownership and Market Power in Banking: Evidence from a World Sample," Journal of Money, Credit and Banking, Blackwell Publishing, vol. 48(2-3), pages 449-483, March.
    12. Giuseppe Croce & Emanuela Ghignoni, 2011. "Overeducation and spatial flexibility in Italian local labour markets," Working Papers in Public Economics 145, Department of Economics and Law, Sapienza University of Roma.
    13. Thomas Crossley & Mario Jametti, 2013. "Pension Benefit Insurance and Pension Plan Portfolio Choice," The Review of Economics and Statistics, MIT Press, vol. 95(1), pages 337-341, March.
    14. Chen, Zhao & Poncet, Sandra & Xiong, Ruixiang, 2020. "Local financial development and constraints on domestic private-firm exports: Evidence from city commercial banks in China," Journal of Comparative Economics, Elsevier, vol. 48(1), pages 56-75.
    15. Catherine Deri-Armstrong, 2009. "The Long-term Effects of Maternal Employment on Daughters’ Later Labour Force Participation and Earnings," Working Papers 0914E, University of Ottawa, Department of Economics.
    16. David G. Blanchflower & Andrew Oswald, 1995. "International Wage Curves," NBER Chapters, in: Differences and Changes in Wage Structures, pages 145-174, National Bureau of Economic Research, Inc.
    17. Philippe Martin & Thierry Mayer & Florian Mayneris, 2008. "Spatial Concentration and Firm-Level Productivity in France," Sciences Po publications 6858, Sciences Po.
    18. Sylvain Chassang & Erik Snowberg & Ben Seymour & Cayley Bowles, 2015. "Accounting for Behavior in Treatment Effects: New Applications for Blind Trials," PLOS ONE, Public Library of Science, vol. 10(6), pages 1-13, June.
    19. Ingo Geishecker & Holger Görg & Jakob Roland Munch, 2007. "Do Labour Market Institutions Matter? Micro-level Wage Effects of International Outsourcing in Three European Countries," Discussion Papers 07/42, University of Nottingham, GEP.
    20. Valentine Fays & Benoît Mahy & François Rycx, 2023. "Wage differences according to workers' origin: The role of working more upstream in GVCs," LABOUR, CEIS, vol. 37(2), pages 319-342, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bba:j00001:v:4:y:2025:i:1:p:51-65:d:326. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Ramona Wang (email available below). General contact details of provider: https://www.anserpress.org .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.