Location, Quality and Choice of Hospital: Evidence from England 2002–2013

Giuseppe Moscelli; Luigi Siciliani; Nils Gutacker; Hugh Stanley Emrys Gravelle

doi:10.1016/j.regsciurbeco.2016.07.001

Location, Quality and Choice of Hospital: Evidence from England 2002–2013

Giuseppe Moscelli, Luigi Siciliani, Nils Gutacker, Hugh Stanley Emrys Gravelle

Research output: Contribution to journal › Article › peer-review

Abstract

We investigate (a) how patient choice of hospital for elective hip replacement is influenced by distance, quality and waiting times, (b) differences in choices between patients in urban and rural locations, (c) the relationship between hospitals' elasticities of demand to quality and the number of local rivals, and how these changed after relaxation of constraints on hospital choice in England in 2006. Using a data set on over 500,000 elective hip replacement patients over the period 2002 to 2013 we find that patients became more likely to travel to a
provider with higher quality or lower waiting times, the proportion of patients bypassing their nearest provider increased from 25% to almost 50%, and hospital elasticity of demand with respect to own quality increased. By 2013 average hospital demand elasticity with respect to readmission rates and waiting times were −0.2 and −0.04. Providers facing more rivals had demand that was more elastic with respect to quality and waiting times. Patients from rural areas have smaller disutility from distance.

Original language	English
Pages (from-to)	112-124
Number of pages	13
Journal	Regional Science and Urban Economics
Volume	60
DOIs	https://doi.org/10.1016/j.regsciurbeco.2016.07.001
Publication status	Published - 21 Jul 2016

Bibliographical note

© 2016 Elsevier B.V. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details. Embargo period : 18 months

Keywords

Choice
Distance
Hospital
Quality
Rurality
Waiting times

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10.1016/j.regsciurbeco.2016.07.001

Location Quality and Patients Choice of Hospital
© 2016 Elsevier B.V. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details. Embargo period : 18 months
Accepted author manuscript, 2.19 MBLicence: Unspecified

Cite this

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title = "Location, Quality and Choice of Hospital: Evidence from England 2002–2013",

abstract = "We investigate (a) how patient choice of hospital for elective hip replacement is influenced by distance, quality and waiting times, (b) differences in choices between patients in urban and rural locations, (c) the relationship between hospitals' elasticities of demand to quality and the number of local rivals, and how these changed after relaxation of constraints on hospital choice in England in 2006. Using a data set on over 500,000 elective hip replacement patients over the period 2002 to 2013 we find that patients became more likely to travel to a provider with higher quality or lower waiting times, the proportion of patients bypassing their nearest provider increased from 25% to almost 50%, and hospital elasticity of demand with respect to own quality increased. By 2013 average hospital demand elasticity with respect to readmission rates and waiting times were −0.2 and −0.04. Providers facing more rivals had demand that was more elastic with respect to quality and waiting times. Patients from rural areas have smaller disutility from distance. ",

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author = "Giuseppe Moscelli and Luigi Siciliani and Nils Gutacker and Gravelle, {Hugh Stanley Emrys}",

note = "{\textcopyright} 2016 Elsevier B.V. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. Further copying may not be permitted; contact the publisher for details. Embargo period : 18 months ",

year = "2016",

month = jul,

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doi = "10.1016/j.regsciurbeco.2016.07.001",

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AU - Siciliani, Luigi

AU - Gutacker, Nils

AU - Gravelle, Hugh Stanley Emrys

N1 - © 2016 Elsevier B.V. All rights reserved. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details. Embargo period : 18 months

PY - 2016/7/21

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N2 - We investigate (a) how patient choice of hospital for elective hip replacement is influenced by distance, quality and waiting times, (b) differences in choices between patients in urban and rural locations, (c) the relationship between hospitals' elasticities of demand to quality and the number of local rivals, and how these changed after relaxation of constraints on hospital choice in England in 2006. Using a data set on over 500,000 elective hip replacement patients over the period 2002 to 2013 we find that patients became more likely to travel to a provider with higher quality or lower waiting times, the proportion of patients bypassing their nearest provider increased from 25% to almost 50%, and hospital elasticity of demand with respect to own quality increased. By 2013 average hospital demand elasticity with respect to readmission rates and waiting times were −0.2 and −0.04. Providers facing more rivals had demand that was more elastic with respect to quality and waiting times. Patients from rural areas have smaller disutility from distance.

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KW - Waiting times

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Location, Quality and Choice of Hospital: Evidence from England 2002–2013

Abstract

Bibliographical note

Keywords

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Other files and links

DoH PRP PRU: ESHCRU - Economics of Health and Social Care Systems

Cite this

Location, Quality and Choice of Hospital: Evidence from England 2002–2013

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Projects

DoH PRP PRU: ESHCRU - Economics of Health and Social Care Systems

Cite this