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The effect of competition on process and outcome quality of hospital care: An empirical analysis for the Netherlands

Author

Listed:
  • Michiel Bijlsma

    () (CPB Netherlands Bureau for Economic Policy Analysis)

  • Pierre Koning

    (CPB Netherlands Bureau for Economic Policy Analysis)

  • Victoria Shestalova

    (CPB Netherlands Bureau for Economic Policy Analysis)

  • Ali Aouragh

    () (CPB Netherlands Bureau for Economic Policy Analysis)

Abstract

The paper focuses on the relationship between competition and quality in the Dutch hospital sector. We analyse the period of 2004-2008, in which a healthcare reform took place in the Netherlands, introducing competition in the healthcare sector. The increased attention to hospital quality and its growing importance in a new institutional environment have resulted in a gradual increase of the voluntary disclosure of quality indicators by Dutch hospitals. We use panel data on Dutch general and academic hospitals in 2004-2008, including both process indicators (e.g., share of operation cancellations on short notice and share of diagnoses within 5 days) and outcome indicators (e.g., mortality rates) of hospital quality. We take the correlation between the disclosure decision and the level of the disclosed quality indicators explicitly into account by estimating a bivariate model. We find that competition explains differences in performance on process indicators, but not on outcome indicators.

Suggested Citation

  • Michiel Bijlsma & Pierre Koning & Victoria Shestalova & Ali Aouragh, 2010. "The effect of competition on process and outcome quality of hospital care: An empirical analysis for the Netherlands," CPB Discussion Paper 157, CPB Netherlands Bureau for Economic Policy Analysis.
  • Handle: RePEc:cpb:discus:157
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    References listed on IDEAS

    as
    1. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," Review of Economic Studies, Oxford University Press, vol. 82(2), pages 457-489.
    2. Zack Cooper & Steve Gibbons & Simon Jones & Alistair McGuire, 2010. "Does Hospital Competition Improve Efficiency? An Analysis of the Recent Market-Based Reforms to the English NHS," CEP Discussion Papers dp0988, Centre for Economic Performance, LSE.
    Full references (including those not matched with items on IDEAS)

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • L8 - Industrial Organization - - Industry Studies: Services
    • H4 - Public Economics - - Publicly Provided Goods

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