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New joints: private providers and rising demand in the English National Health Service

Author

Listed:
  • Elaine Kelly

    (Institute for Fiscal Studies and Institute for Fiscal Studies)

  • George Stoye

    (Institute for Fiscal Studies and Institute for Fiscal Studies)

Abstract

This paper investigates how changes in hospital choice sets affect levels of patient demand for elective hospital care. We exploit a set of reforms in England that opened up the market for publicly-funded patients to private hospitals. Impacts on demand are estimated using variation in distance to these private hospitals, within regions where supply constraints are fixed. We find that the reforms increased demand for publicly-funded procedures. For public hospitals, volumes remained unchanged but waiting times fell. Taken together, our results provide new insights into how individuals make choices about their care and the scope of competition between hospitals.

Suggested Citation

  • Elaine Kelly & George Stoye, 2015. "New joints: private providers and rising demand in the English National Health Service," IFS Working Papers W15/22, Institute for Fiscal Studies.
    • Handle: RePEc:ifs:ifsewp:15/22
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    Cited by:

    1. Bíró, Anikó & Hellowell, Mark, 2016. "Public–private sector interactions and the demand for supplementary health insurance in the United Kingdom," Health Policy, Elsevier, vol. 120(7), pages 840-847.
    2. Cooper, Zack & Gibbons, Stephen & Skellern, Matthew, 2018. "Does competition from private surgical centres improve public hospitals' performance? Evidence from the English National Health Service," Journal of Public Economics, Elsevier, vol. 166(C), pages 63-80.
    3. Brenna, Elenka & Polistena, Barbara & Spandonaro, Federico, 2023. "Analysing outpatient care access for planning purposes: The Basilicata Region experience," Evaluation and Program Planning, Elsevier, vol. 99(C).
    4. Fletcher, Simon & Eddama, Oya & Anderson, Michael & Meacock, Rachel & Wattal, Vasudha & Allen, Pauline & Peckham, Stephen, 2024. "The impact of NHS outsourcing of elective care to the independent sector on outcomes for patients, healthcare professionals and the United Kingdom health care system: A rapid narrative review of liter," Health Policy, Elsevier, vol. 150(C).
    5. Fletcher, Simon & Eddama, Oya & Anderson, Michael & Meacock, Rachel & Wattal, Vasudha & Allen, Pauline & Peckham, Stephen, 2024. "The impact of NHS outsourcing of elective care to the independent sector on outcomes for patients, healthcare professionals and the United Kingdom health care system: a rapid narrative review of literature," LSE Research Online Documents on Economics 125828, London School of Economics and Political Science, LSE Library.
    6. Laurie Rachet-Jacquet & Nils Gutacker & Luigi Siciliani, 2019. "The causal effect of hospital volume on health gains from hip replacement surgery," Working Papers 168cherp, Centre for Health Economics, University of York.
    7. Dardanoni, V.; & Laudicella, M.; & Li Donni, P.;, 2018. "Hospital Choice in the NHS," Health, Econometrics and Data Group (HEDG) Working Papers 18/04, HEDG, c/o Department of Economics, University of York.
    8. Rachet-Jacquet, Laurie & Gutacker, Nils & Siciliani, Luigi, 2021. "Scale economies in the health sector: The effect of hospital volume on health gains from hip replacement surgery," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 704-729.

    More about this item

    Keywords

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    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L33 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Comparison of Public and Private Enterprise and Nonprofit Institutions; Privatization; Contracting Out

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