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The effects of decentralisation and competition on hospital management and performance in France

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  • Carine Milcent

    (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

  • Laurent Gobillon

    (PSE - Paris School of Economics - UP1 - Université Paris 1 Panthéon-Sorbonne - ENS-PSL - École normale supérieure - Paris - PSL - Université Paris sciences et lettres - EHESS - École des hautes études en sciences sociales - ENPC - École des Ponts ParisTech - CNRS - Centre National de la Recherche Scientifique - INRAE - Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement)

Abstract

It is widely believed that the goal of keeping health expenditures under control while increasing the quality of the healthcare system can best be achieved by giving a greater role to market forces. This column evaluates the effect of a pro-competition reform implemented in France over 2004-2008 on hospital quality. It finds that the impact on quality depends on the managerial autonomy of hospitals. And due to the French healthcare market structure, the overall effect of the reform has been limited.

Suggested Citation

  • Carine Milcent & Laurent Gobillon, 2017. "The effects of decentralisation and competition on hospital management and performance in France," Post-Print halshs-01990996, HAL.
    • Handle: RePEc:hal:journl:halshs-01990996
    Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-01990996
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    File URL: https://shs.hal.science/halshs-01990996/document
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    References listed on IDEAS

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    1. Gobillon, Laurent & Milcent, Carine, 2017. "Competition and hospital quality: Evidence from a French natural experiment," CEPR Discussion Papers 11773, C.E.P.R. Discussion Papers.
    2. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    3. Martin Gaynor & Rodrigo Moreno-Serra & Carol Propper, 2013. "Death by Market Power: Reform, Competition, and Patient Outcomes in the National Health Service," American Economic Journal: Economic Policy, American Economic Association, vol. 5(4), pages 134-166, November.
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    Cited by:

    1. Field, Robert I. & Keller, Catherine & Louazel, Michel, 2020. "Can governments push providers to collaborate? A comparison of hospital network reforms in France and the United States," Health Policy, Elsevier, vol. 124(10), pages 1100-1107.

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