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The effect of hospital ownership on quality of care: evidence from England

Author

Listed:
  • Giuseppe Moscelli

    (Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, York, UK)

  • Hugh Gravelle

    (Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, York, UK.)

  • Luigi Siciliani

    (Department of Economics and Related Studies, University of York, York, UK)

  • Nils Gutacker

    (Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, York, UK)

Abstract

We investigate whether quality of care differs between public and private hospitals in England with data on 3.8 million publicly-funded patients receiving 133 planned (non-emergency) treatments in 393 public and 190 private hospitalsites. Private hospitals treat patients with fewer comorbidities and past hospitalisations. Controlling for observed patient characteristics and treatment type, private hospitals have fewer emergency readmissions. Conversely, after instrumenting the choice of hospital type by the difference in distances from the patient to the nearest public and the nearest private hospital, the effect of ownership is smaller and statistically insignificant. Similar results are obtained with coarsened exact matching. We also find no quality differences between hospitals specialising in planned treatments and other hospitals, nor between for-profit and not-for-profit private hospitals. Our results show the importance of controlling for unobserved patient heterogeneity when comparing quality of public and private hospitals.

Suggested Citation

  • 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.
  • Handle: RePEc:chy:respap:145cherp
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    File URL: https://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP145_hospital_ownership_quality_care_evidence.pdf
    File Function: First version, 2017
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    References listed on IDEAS

    as
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    More about this item

    Keywords

    ownership; hospital; quality; choice; distance; endogeneity.;

    JEL classification:

    • C36 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Instrumental Variables (IV) Estimation
    • H44 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Goods: Mixed Markets
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L33 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Comparison of Public and Private Enterprise and Nonprofit Institutions; Privatization; Contracting Out

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