By the same authors

Does hospital competition improve efficiency? The effect of the patient choice reform in England

Research output: Working paper › Discussion paper

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Does hospital competition improve efficiency? The effect of the patient choice reform in England. / Longo, Francesco; Siciliani, Luigi; Moscelli, Giuseppe; Gravelle, Hugh Stanley Emrys.

York, UK : Centre for Health Economics, University of York, 2017. p. 1-27 (CHE Research Paper; No. 149).

Research output: Working paper › Discussion paper

Harvard

Longo, F, Siciliani, L, Moscelli, G & Gravelle, HSE 2017 'Does hospital competition improve efficiency? The effect of the patient choice reform in England' CHE Research Paper, no. 149, Centre for Health Economics, University of York, York, UK, pp. 1-27.

APA

Longo, F., Siciliani, L., Moscelli, G., & Gravelle, H. S. E. (2017). Does hospital competition improve efficiency? The effect of the patient choice reform in England. (pp. 1-27). (CHE Research Paper; No. 149). York, UK: Centre for Health Economics, University of York.

Vancouver

Longo F, Siciliani L, Moscelli G, Gravelle HSE. Does hospital competition improve efficiency? The effect of the patient choice reform in England. York, UK: Centre for Health Economics, University of York. 2017 Nov, p. 1-27. (CHE Research Paper; 149).

Author

Longo, Francesco; Siciliani, Luigi; Moscelli, Giuseppe; Gravelle, Hugh Stanley Emrys / Does hospital competition improve efficiency? The effect of the patient choice reform in England.

York, UK : Centre for Health Economics, University of York, 2017. p. 1-27 (CHE Research Paper; No. 149).

Research output: Working paper › Discussion paper

Bibtex - Download

@misc{0b601da817fe4f8c83c10b406d1e3f2c,
title = "Does hospital competition improve efficiency? The effect of the patient choice reform in England",
abstract = "We use the 2006 relaxation of constraints on patient choice of hospital in the English NHS to investigate the effect of hospital competition on dimensions of efficiency including indicators of resource management (admissions per bed, bed occupancy rate, proportion of day cases, cancelled elective operations, proportion of untouched meals) and costs (cleaning services costs, laundry andlinen costs, reference cost index for overall and elective activity). We employ a quasi difference-indifference approach and estimate seemingly unrelated regressions and unconditional quantile regressions with data on hospital trusts from 2002/03 to 2010/11. Our findings suggest that increased competition had mixed effects on efficiency. An additional equivalent rival increased admissions per bed and the proportion of day cases by 1.1 and 3.8 percentage points, and reduced the proportion of untouched meals by 3.5 percentage points, but it also increased the number of cancelled elective operations by 2.6%. Unconditional quantile regression results indicate that hospitals with low efficiency, as  measured by fewer admissions per bed and a smaller proportion of day cases, are more responsive to competition.",
keywords = "competition, efficiency, choice, hospital, difference-in-difference",
author = "Francesco Longo and Luigi Siciliani and Giuseppe Moscelli and Gravelle, {Hugh Stanley Emrys}",
year = "2017",
month = "11",
series = "CHE Research Paper",
publisher = "Centre for Health Economics, University of York",
number = "149",
pages = "1--27",
type = "WorkingPaper",
institution = "Centre for Health Economics, University of York",

}

RIS (suitable for import to EndNote) - Download

TY - UNPB

T1 - Does hospital competition improve efficiency? The effect of the patient choice reform in England

AU - Longo,Francesco

AU - Siciliani,Luigi

AU - Moscelli,Giuseppe

AU - Gravelle,Hugh Stanley Emrys

PY - 2017/11

Y1 - 2017/11

N2 - We use the 2006 relaxation of constraints on patient choice of hospital in the English NHS to investigate the effect of hospital competition on dimensions of efficiency including indicators of resource management (admissions per bed, bed occupancy rate, proportion of day cases, cancelled elective operations, proportion of untouched meals) and costs (cleaning services costs, laundry andlinen costs, reference cost index for overall and elective activity). We employ a quasi difference-indifference approach and estimate seemingly unrelated regressions and unconditional quantile regressions with data on hospital trusts from 2002/03 to 2010/11. Our findings suggest that increased competition had mixed effects on efficiency. An additional equivalent rival increased admissions per bed and the proportion of day cases by 1.1 and 3.8 percentage points, and reduced the proportion of untouched meals by 3.5 percentage points, but it also increased the number of cancelled elective operations by 2.6%. Unconditional quantile regression results indicate that hospitals with low efficiency, as  measured by fewer admissions per bed and a smaller proportion of day cases, are more responsive to competition.

AB - We use the 2006 relaxation of constraints on patient choice of hospital in the English NHS to investigate the effect of hospital competition on dimensions of efficiency including indicators of resource management (admissions per bed, bed occupancy rate, proportion of day cases, cancelled elective operations, proportion of untouched meals) and costs (cleaning services costs, laundry andlinen costs, reference cost index for overall and elective activity). We employ a quasi difference-indifference approach and estimate seemingly unrelated regressions and unconditional quantile regressions with data on hospital trusts from 2002/03 to 2010/11. Our findings suggest that increased competition had mixed effects on efficiency. An additional equivalent rival increased admissions per bed and the proportion of day cases by 1.1 and 3.8 percentage points, and reduced the proportion of untouched meals by 3.5 percentage points, but it also increased the number of cancelled elective operations by 2.6%. Unconditional quantile regression results indicate that hospitals with low efficiency, as  measured by fewer admissions per bed and a smaller proportion of day cases, are more responsive to competition.

KW - competition

KW - efficiency

KW - choice

KW - hospital

KW - difference-in-difference

M3 - Discussion paper

T3 - CHE Research Paper

SP - 1

EP - 27

BT - Does hospital competition improve efficiency? The effect of the patient choice reform in England

PB - Centre for Health Economics, University of York

ER -

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