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Does quality affect patients’ choice of doctor? Evidence from the UK

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  • Santos, R.
  • Gravelle, H.
  • Propper, C.

Abstract

Provider competition is a currently popular healthcare reform model. A necessary condition for greater competition to improve quality is that providers will face higher demand if they improve their quality. In this paper we test this crucial assumption in an important part of the health care market by examining whether quality affects the choice of family doctor. We use data on the choices made by 3.4 million English patients from amongst nearly 1000 family doctor practices to estimate the determinants of choice and, in particular, whether quality affects choice. The English setting is a particularly useful test bed since all individuals are entitled to register with a family physician and generally cannot access non-emergency hospital care without doing so. All care is free, so choice of family doctor is not affected by price. Moreover, measures of clinicalquality are publicly available. We find that patients do respond to quality and are willing to travel further to higher quality practices. Our estimates suggest that a one standard deviation increase in the publicly available measure of quality would increase the number of patients a practice would attract by around 15% of the practice patient list.

Suggested Citation

  • Santos, R. & Gravelle, H. & Propper, C., 2014. "Does quality affect patients’ choice of doctor? Evidence from the UK," Health, Econometrics and Data Group (HEDG) Working Papers 14/21, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:14/21
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    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. #HEJC papers for August 2013
      by academichealtheconomists in The Academic Health Economists' Blog on 2013-08-01 04:00:48

    Citations

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    Cited by:

    1. Nadja Kairies-Schwarz, 2014. "Altruism Heterogeneity and Quality Competition Among Healthcare Providers," Ruhr Economic Papers 0507, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    2. Walter Beckert, 2015. "Choice in the Presence of Experts," Birkbeck Working Papers in Economics and Finance 1503, Birkbeck, Department of Economics, Mathematics & Statistics.
    3. Davari, Soheil & Kilic, Kemal & Naderi, Siamak, 2016. "A heuristic approach to solve the preventive health care problem with budget and congestion constraints," Applied Mathematics and Computation, Elsevier, vol. 276(C), pages 442-453.
    4. Beckert, Walter, 2018. "Choice in the presence of experts: The role of general practitioners in patients’ hospital choice," Journal of Health Economics, Elsevier, vol. 60(C), pages 98-117.
    5. Soheil Davari & Kemal Kilic & Gurdal Ertek, 2015. "Fuzzy bi-objective preventive health care network design," Health Care Management Science, Springer, vol. 18(3), pages 303-317, September.
    6. repec:zbw:rwirep:0507 is not listed on IDEAS
    7. Piia Pekola & Ismo Linnosmaa & Hennamari Mikkola, 2017. "Does Competition Have an Effect on Price and Quality in Physiotherapy?," Health Economics, John Wiley & Sons, Ltd., vol. 26(10), pages 1278-1290, October.
    8. Andrew Sfekas, 2019. "Quality Competition and Intra-System Substitution in the Hospital Industry," American Journal of Health Economics, MIT Press, vol. 5(1), pages 65-96, Winter.
    9. Christopher J. Cronin & David K. Guilkey & Ilene S. Speizer, 2019. "Measurement error in discrete health facility choice models: An example from urban Senegal," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 34(7), pages 1102-1120, November.

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    More about this item

    Keywords

    quality; demand; healthcare; choice; competition; family practice;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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