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Market concentration, supply, quality and prices paid by local authorities in the English care home market

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  • Pudney, Stephen
  • Espuny Pujol, Ferran
  • Hancock, Ruth
  • Hviid, Morten
  • Morciano, Marcello

Abstract

We investigate the impact of exogenous local conditions which favour high market concentration on supply, price and quality in local markets for care homes for older people in England. We extend the existing literature in: (i) considering supply capacity as a market outcome alongside price and quality; (ii) taking account of the chain structure of care home supply and differences between the nursing home and residential care home sectors; (iii) introducing a new econometric approach based on reduced form relationships that treats market concentration as a jointly-determined outcome of a complex contested market. We find that areas susceptible to a high degree of market concentration tend to have greatly restricted supply of care home places and (to a lesser extent) a higher average public cost, than areas susceptible to low degree of market concentration. There is no significant evidence that conditions favouring high market concentration affect average care home quality.

Suggested Citation

  • Pudney, Stephen & Espuny Pujol, Ferran & Hancock, Ruth & Hviid, Morten & Morciano, Marcello, 2019. "Market concentration, supply, quality and prices paid by local authorities in the English care home market," ISER Working Paper Series 2019-10, Institute for Social and Economic Research.
    • Handle: RePEc:ese:iserwp:2019-10
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    1. Ferran Espuny Pujol & Ruth Hancock & Morten Hviid & Marcello Morciano & Stephen Pudney, 2021. "Market concentration, supply, quality and prices paid by local authorities in the English care home market," Health Economics, John Wiley & Sons, Ltd., vol. 30(8), pages 1886-1909, August.
    2. Paul L. Joskow, 1980. "The Effects of Competition and Regulation on Hospital Bed Supply and the Reservation Quality of the Hospital," Bell Journal of Economics, The RAND Corporation, vol. 11(2), pages 421-447, Autumn.
    3. Allan, Stephen & Gousia, Katerina & Forder, Julien, 2021. "Exploring differences between private and public prices in the English care homes market," Health Economics, Policy and Law, Cambridge University Press, vol. 16(2), pages 138-153, April.
    4. Nyman, John A, 1994. "The Effects of Market Concentration and Excess Demand on the Price of Nursing Home Care," Journal of Industrial Economics, Wiley Blackwell, vol. 42(2), pages 193-204, June.
    5. Lucas, Robert Jr, 1976. "Econometric policy evaluation: A critique," Carnegie-Rochester Conference Series on Public Policy, Elsevier, vol. 1(1), pages 19-46, January.
    6. Dewaelheyns, Nico & Eeckloo, Kristof & Van Herck, Gustaaf & Van Hulle, Cynthia & Vleugels, Arthur, 2009. "Do non-profit nursing homes separate governance roles?: The impact of size and ownership characteristics," Health Policy, Elsevier, vol. 90(2-3), pages 188-195, May.
    7. Mehdi Farsi & Massimo Filippini, 2004. "An Empirical Analysis of Cost Efficiency in Non‐profit and Public Nursing Homes," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 75(3), pages 339-365, September.
    8. Julien Forder & Ann Netten, 2000. "The price of placements in residential and nursing home care: the effects of contracts and competition," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 643-657, October.
    9. Hirth, Richard A., 1999. "Consumer information and competition between nonprofit and for-profit nursing homes," Journal of Health Economics, Elsevier, vol. 18(2), pages 219-240, April.
    10. Barron, David N. & West, Elizabeth, 2017. "The quasi-market for adult residential care in the UK: Do for-profit, not-for-profit or public sector residential care and nursing homes provide better quality care?," Social Science & Medicine, Elsevier, vol. 179(C), pages 137-146.
    11. Morciano, Marcello & Checkland, Katherine & Billings, Jenny & Coleman, Anna & Stokes, Jonathan & Tallack, Charles & Sutton, Matt, 2020. "New integrated care models in England associated with small reduction in hospital admissions in longer-term: A difference-in-differences analysis," Health Policy, Elsevier, vol. 124(8), pages 826-833.
    12. James Banks & Carl Emmerson & Gemma Tetlow, 2005. "Estimating pension wealth of ELSA respondents," IFS Working Papers W05/09, Institute for Fiscal Studies.
    13. Grabowski, David C. & Hirth, Richard A., 2003. "Competitive spillovers across non-profit and for-profit nursing homes," Journal of Health Economics, Elsevier, vol. 22(1), pages 1-22, January.
    14. Cécile Martin & Tiphaine Jérôme, 2016. "Cost (In)Efficiency and Institutional Pressures in Nursing Home Chains," European Accounting Review, Taylor & Francis Journals, vol. 25(4), pages 687-718, October.
    15. Forder, Julien & Allan, Stephen, 2014. "The impact of competition on quality and prices in the English care homes market," Journal of Health Economics, Elsevier, vol. 34(C), pages 73-83.
    16. Zhao, Xin, 2016. "Competition, information, and quality: Evidence from nursing homes," Journal of Health Economics, Elsevier, vol. 49(C), pages 136-152.
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    1. Ferran Espuny Pujol & Ruth Hancock & Morten Hviid & Marcello Morciano & Stephen Pudney, 2021. "Market concentration, supply, quality and prices paid by local authorities in the English care home market," Health Economics, John Wiley & Sons, Ltd., vol. 30(8), pages 1886-1909, August.
    2. Almorox, Eduardo Gonzalo & Stokes, Jonathan & Morciano, Marcello, 2022. "Has COVID-19 changed carer's views of health and care integration in care homes? A sentiment difference-in-difference analysis of on-line service reviews," Health Policy, Elsevier, vol. 126(11), pages 1117-1123.
    3. Cutler, Henry & Gu, Yuanyuan & Bilgrami, Anam & Partington, Andrew, 2023. "The 2021 proposal to increase market forces in the Australian residential aged-care sector," Health Policy, Elsevier, vol. 127(C), pages 60-65.

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    JEL classification:

    • N0 - Economic History - - General
    • L81 - Industrial Organization - - Industry Studies: Services - - - Retail and Wholesale Trade; e-Commerce

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