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Does hospital competition save lives? Evidence from the English NHS patient choice reforms

Cooper, Zack, Gibbons, Stephen, Jones, Simon and McGuire, Alistair (2011) Does hospital competition save lives? Evidence from the English NHS patient choice reforms. The Economic Journal, 121 (554). F228-F260. ISSN 0013-0133

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Identification Number: 10.1111/j.1468-0297.2011.02449.x


Recent substantive reforms to the English National Health Service expanded patient choice and encouraged hospitals to compete within a market with fixed prices. This study investigates whether these reforms led to improvements in hospital quality. We use a difference-in-difference-style estimator to test whether hospital quality (measured using mortality from acute myocardial infarction) improved more quickly in more competitive markets after these reforms came into force in 2006. We find that after the reforms were implemented, mortality fell (i.e. quality improved) for patients living in more competitive markets. Our results suggest that hospital competition can lead to improvements in hospital quality.

Item Type: Article
Official URL:
Additional Information: © 2011 The Authors. The Economic Journal published by John Wiley & Sons Ltd on behalf of Royal Economic Society.
Divisions: Social Policy
LSE Health
Geography & Environment
Subjects: H Social Sciences > HB Economic Theory
R Medicine > RA Public aspects of medicine
JEL classification: L - Industrial Organization > L1 - Market Structure, Firm Strategy, and Market Performance
R - Urban, Rural, and Regional Economics > R0 - General
I - Health, Education, and Welfare > I1 - Health
Date Deposited: 07 Aug 2012 13:03
Last Modified: 20 Oct 2021 00:28
Funders: London School of Economics and Political Science PhD Studentship, Economic and Social Research Council (ESRC) Postdoctoral Fellowship

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