By: |
Zack Cooper;
Stephen Gibbons;
Simon Jones;
Alistair McGuire |
Abstract: |
This paper uses a difference-in-difference estimator to test whether the
introduction of patientchoice and hospital competition in the English NHS in
January 2006 has prompted hospitalsto become more efficient. Efficiency was
measured using hospitals' average length of stay(LOS) for patients undergoing
elective hip replacement. LOS was broken down into its twokey components: the
time from a patient's admission until their surgery and the time fromtheir
surgery until their discharge. Our results illustrate that hospitals exposed
to competitionafter a wave of market-based reforms took steps to shorten the
time patients were in thehospital prior to their surgery, which resulted in a
decrease in overall LOS. We find thathospitals shortened patients' LOS without
compromising patient outcomes or by operating onhealthier, wealthier or
younger patients. Our results suggest that hospital competition withinmarkets
with fixed prices can increase hospital efficiency. |
Keywords: |
Hospital Competition, Market Structure, Prospective Payment, Incentive Structure |
JEL: |
C21 I18 L1 R0 |
Date: |
2010–06 |
URL: |
http://d.repec.org/n?u=RePEc:cep:cepdps:dp0988&r=ind |