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Competition and Quality: Evidence from the NHS Internal Market 1991-1999

  • Propper, Carol

    (University of Bristol)

  • Simon Burgess
  • Denise Abraham

Payer-driven competition has been widely advocated as a means of increasing efficiency in health care markets. The 1990s reforms to the UK health service followed this path. We examine whether competition led to better outcomes for patients, as measured by death rates after treatment following heart attacks. Using data on mortality as a measure of hospital quality and exploiting the policy change during the 1990s, we find that the relationship between competition and quality of care appears to be negative.

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Paper provided by Royal Economic Society in its series Royal Economic Society Annual Conference 2003 with number 169.

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Date of creation: 04 Jun 2003
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Handle: RePEc:ecj:ac2003:169
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  1. 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.
  2. Dranove, David & White, William D, 1994. "Recent Theory and Evidence on Competition in Hospital Markets," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 169-209, Spring.
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