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Location, quality and choice of hospital: Evidence from England 2002–2013

Author

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  • Moscelli, Giuseppe
  • Siciliani, Luigi
  • Gutacker, Nils
  • Gravelle, Hugh

Abstract

We investigate (a) how patient choice of hospital for elective hip replacement is influenced by distance, quality and waiting times, (b) differences in choices between patients in urban and rural locations, (c) the relationship between hospitals' elasticities of demand to quality and the number of local rivals, and how these changed after relaxation of constraints on hospital choice in England in 2006. Using a data set on over 500,000 elective hip replacement patients over the period 2002 to 2013 we find that patients became more likely to travel to a provider with higher quality or lower waiting times, the proportion of patients bypassing their nearest provider increased from 25% to almost 50%, and hospital elasticity of demand with respect to own quality increased. By 2013 average hospital demand elasticity with respect to readmission rates and waiting times were −0.2 and −0.04. Providers facing more rivals had demand that was more elastic with respect to quality and waiting times. Patients from rural areas have smaller disutility from distance.

Suggested Citation

  • Moscelli, Giuseppe & Siciliani, Luigi & Gutacker, Nils & Gravelle, Hugh, 2016. "Location, quality and choice of hospital: Evidence from England 2002–2013," Regional Science and Urban Economics, Elsevier, vol. 60(C), pages 112-124.
  • Handle: RePEc:eee:regeco:v:60:y:2016:i:c:p:112-124
    DOI: 10.1016/j.regsciurbeco.2016.07.001
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    References listed on IDEAS

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    Citations

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    Cited by:

    1. Giuseppe Moscelli & Hugh Gravelle & Luigi Siciliani, 2016. "Market structure, patient choice and hospital quality for elective patients," Working Papers 139cherp, Centre for Health Economics, University of York.
    2. repec:eee:jhecon:v:57:y:2018:i:c:p:131-146 is not listed on IDEAS
    3. repec:eee:jhecon:v:57:y:2018:i:c:p:290-314 is not listed on IDEAS
    4. Dardanoni, V.; & Laudicella, M.; & Li Donni, P.;, 2018. "Hospital Choice in the NHS," Health, Econometrics and Data Group (HEDG) Working Papers 18/04, HEDG, c/o Department of Economics, University of York.
    5. Giuseppe Moscelli & Hugh Gravelle & Luigi Siciliani & Nils Gutacker, 2017. "The effect of hospital ownership on quality of care: evidence from England," Working Papers 145cherp, Centre for Health Economics, University of York.

    More about this item

    Keywords

    Hospital; Choice; Quality; Waiting times; Distance; Rurality;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L15 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Information and Product Quality
    • R22 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Other Demand

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