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Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms

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  • Zack Cooper
  • Stephen Gibbons
  • Simon Jones
  • Alistair McGuire

Abstract

Recent substantive reforms to the English National Health Service expanded patient choice and encouraged hospitals to compete within a market with fixed prices. This study investigates whether these reforms led to improvements in hospital quality. We use a difference-in-difference-style estimator to test whether hospital quality (measured using mortality from acute myocardial infarction) improved more quickly in more competitive markets after these reforms came into force in 2006. We find that after the reforms were implemented, mortality fell (i.e. quality improved) for patients living in more competitive markets. Our results suggest that hospital competition can lead to improvements in hospital quality.
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Suggested Citation

  • Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
  • Handle: RePEc:ecj:econjl:v:121:y:2011:i:554:p:f228-f260
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    More about this item

    JEL classification:

    • L1 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance
    • R0 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - General
    • I1 - Health, Education, and Welfare - - Health

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