Does competition from private surgical centres improve public hospitals’ performance? Evidence from the English National Health Service

Cooper, Zack, Gibbons, Stephen and Skellern, Matthew (2016) Does competition from private surgical centres improve public hospitals’ performance? Evidence from the English National Health Service. CEP Discussion Paper, No 1434. Centre for Economic Performance, London School of Economics and Political Science, London, UK.

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Abstract

This paper examines the impact of competition from government-facilitated entry of private, specialty surgical centres on the efficiency and case mix of incumbent public hospitals within the English NHS. We exploit the fact that the government chose the location of these surgical centres (Independent Sector Treatment Centres or ISTCs) based on nearby public hospitals’ waiting times – not length of stay or clinical quality – to construct treatment and control groups that are comparable with respect to key outcome variables of interest. Using a difference-in-difference estimation strategy, we find that ISTC entry led to greater efficiency – measured by presurgery length of stay for hip and knee replacements – at nearby public hospitals. However, these new entrants took on healthier patients and left incumbent hospitals treating patients who were sicker, and who stayed in hospital longer after surgery.

Item Type:	Monograph (Discussion Paper)
Official URL:	http://cep.lse.ac.uk/
Additional Information:	© 2016 The Authors
Library of Congress subject classification:	R Medicine > RA Public aspects of medicine
Journal of Economic Literature Classification System:	C - Mathematical and Quantitative Methods > C2 - Econometric Methods: Single Equation Models; Single Variables > C23 - Models with Panel Data H - Public Economics > H5 - National Government Expenditures and Related Policies > H57 - Procurement I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets L - Industrial Organization > L1 - Market Structure, Firm Strategy, and Market Performance L - Industrial Organization > L3 - Nonprofit Organizations and Public Enterprise > L33 - Comparison of Public and Private Enterprises; Privatization; Contracting Out R - Urban, Rural, and Regional Economics > R1 - General Regional Economics > R12 - Size and Spatial Distributions of Regional Economic Activity; Interregional Trade
Sets:	Research centres and groups > Centre for Economic Performance (CEP)
Identification Number:	No 1434
Project and Funder Information:	Project ID Funder Name Funder ID UNSPECIFIED Economic and Social Research Council http://dx.doi.org/10.13039/501100000269
Funders:	Economic and Social Research Council
Date Deposited:	09 Sep 2016 11:44
URL:	http://eprints.lse.ac.uk/67662/

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