Patient choice and the effects of hospital market structure on mortality for AMI, hip fracture and stroke patients

Hugh Gravelle; Giuseppe Moscelli; Rita Santos; Luigi Siciliani

Patient choice and the effects of hospital market structure on mortality for AMI, hip fracture and stroke patients

Hugh Gravelle, Giuseppe Moscelli, Rita Santos, Luigi Siciliani

Research output: Working paper › Discussion paper

Abstract

We examine (a) the effect of market structure on the level of mortality for AMI, hip fracture, and stroke between 2002/3 and 2010/11 and (b) whether this effect changed after the introduction of Choice policy in 2006 which gave patients the right to a wider choice of hospital. For AMI and hip fracture, hospitals with more rivals had higher mortality at the beginning of the period but this effect became smaller over the period. We find that the decline in the detrimental effect of market structure predated the introduction of Choice. Market structure had no effect on stroke mortality.

Original language	English
Place of Publication	York, UK
Publisher	Centre for Health Economics, University of York
Pages	1-57
Number of pages	57
Publication status	Published - Dec 2014

Publication series

Name	CHE Research Paper
Publisher	Centre for Health Economics, University of York
No.	106

Keywords

competition
quality
hospital
choice

Access to Document

CHERP106_patient_choice_hospital_mortalityFinal published version, 1.93 MB

http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP106_patient_choice_hospital_mortality.pdf

Cite this

Gravelle, H., Moscelli, G., Santos, R., & Siciliani, L. (2014). Patient choice and the effects of hospital market structure on mortality for AMI, hip fracture and stroke patients. (pp. 1-57). (CHE Research Paper; No. 106). Centre for Health Economics, University of York. http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP106_patient_choice_hospital_mortality.pdf

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Gravelle, H , Moscelli, G , Santos, R & Siciliani, L 2014 'Patient choice and the effects of hospital market structure on mortality for AMI, hip fracture and stroke patients' CHE Research Paper, no. 106, Centre for Health Economics, University of York, York, UK, pp. 1-57. <http://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP106_patient_choice_hospital_mortality.pdf>

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N2 - We examine (a) the effect of market structure on the level of mortality for AMI, hip fracture, and stroke between 2002/3 and 2010/11 and (b) whether this effect changed after the introduction of Choice policy in 2006 which gave patients the right to a wider choice of hospital. For AMI and hip fracture, hospitals with more rivals had higher mortality at the beginning of the period but this effect became smaller over the period. We find that the decline in the detrimental effect of market structure predated the introduction of Choice. Market structure had no effect on stroke mortality.

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