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Spatial competition and quality: Evidence from the English family doctor market

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  • Gravelle, Hugh
  • Liu, Dan
  • Propper, Carol
  • Santos, Rita

Abstract

We examine whether family doctor firms in England respond to local competition by increasing their quality. We measure quality in terms of clinical performance and patient-reported satisfaction to capture its multi-dimensional nature. We use a panel covering 8 years for over 8000 English general practices. We measure competition as the number of rival doctors within a small distance and control for a large number of potential confounders. We find that increases in local competition are associated with increases in patient satisfaction and to a lesser extent in clinical quality. However, the magnitude of the effect is small.

Suggested Citation

  • Gravelle, Hugh & Liu, Dan & Propper, Carol & Santos, Rita, 2019. "Spatial competition and quality: Evidence from the English family doctor market," Journal of Health Economics, Elsevier, vol. 68(C).
  • Handle: RePEc:eee:jhecon:v:68:y:2019:i:c:s0167629618304077
    DOI: 10.1016/j.jhealeco.2019.102249
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 28th October 2019
      by Chris Sampson in The Academic Health Economists' Blog on 2019-10-28 12:00:05

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    Cited by:

    1. Jens Dietrichson & Lina Maria Ellegård & Gustav Kjellsson, 2020. "Patient choice, entry, and the quality of primary care: Evidence from Swedish reforms," Health Economics, John Wiley & Sons, Ltd., vol. 29(6), pages 716-730, June.
    2. Josh Matti, 2020. "Reaching for the Stars: Spatial Competition and Consumer Reviews," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 48(3), pages 339-353, September.
    3. Vengberg, Sofie & Fredriksson, Mio & Winblad, Ulrika, 2019. "Patient choice and provider competition – Quality enhancing drivers in primary care?," Social Science & Medicine, Elsevier, vol. 226(C), pages 217-224.

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    More about this item

    Keywords

    Quality; Healthcare; Choice; Competition; Family; Physicians;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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