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Mapping choice in the NHS: Analysis of routine data


  • Mike Damiani
  • Jennifer Dixon
  • Carol Propper



New policies in the National Health Service in England seek to extend the choice of provider of care for patients on waiting lists for elective surgery. We try to identify where in the country there are likely to be most constraints on choice for patients waiting over 6 months for elective care. The available supply and demand for hsoptial care, based on a 60 minute travel time from individual location, is estimated using routinely collected information. We show that for most of the population there is already a significant potential choice of hospital. The number of available and unoccupied beds within 60 minutes travel time is lowest in the Scottish Borders, North Yorkshire, and parts of East Anglia, Lincolnshire, Devon and Cornwall. Adding in private facilities does not alter this pattern. Putting together demand with this supply, the number waiting over 6 months per bed within 60 minutes travel time is highest in the South East (except London), parts of the South West (Cornwall, Bristol), East Anglia and the Welsh Borders. We conlcude that people in the South East outside London, East Anglia, and parts of the South West are likely to have to travel further to exercise meaningful choice.

Suggested Citation

  • Mike Damiani & Jennifer Dixon & Carol Propper, 2004. "Mapping choice in the NHS: Analysis of routine data," The Centre for Market and Public Organisation 04/095, Department of Economics, University of Bristol, UK.
  • Handle: RePEc:bri:cmpowp:04/095

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    References listed on IDEAS

    1. Hugh Gravelle & Peter Smith & Ana Xavier, 2003. "Performance signals in the public sector: the case of health care," Oxford Economic Papers, Oxford University Press, vol. 55(1), pages 81-103, January.
    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.
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    Cited by:

    1. Burgess, Simon & Propper, Carol & Wilson, Deborah, 2005. "Extending Choice In English Health Care: The implications of the economic evidence," CEPR Discussion Papers 5328, C.E.P.R. Discussion Papers.
    2. Mark Dusheiko & Maria Goddard & Hugh Gravelle & Rowena Jacobs, 2006. "Trends in health care commissioning in the English NHS: an empirical analysis," Working Papers 011cherp, Centre for Health Economics, University of York.
    3. Helen Simpson, 2009. "Productivity In Public Services," Journal of Economic Surveys, Wiley Blackwell, vol. 23(2), pages 250-276, April.

    More about this item


    NHS choice; hospital care; travel to hospital;

    JEL classification:

    • H4 - Public Economics - - Publicly Provided Goods
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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