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Spatial competition and quality: Evidence from the English family doctor market

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Publication details

JournalJournal of Health Economics
DateSubmitted - 1 May 2018
DateAccepted/In press - 9 Oct 2019
DateE-pub ahead of print (current) - 17 Oct 2019
Early online date17/10/19
Original languageEnglish


We examine whether family doctor firms in England respond to local competition by increasing their quality. We measure quality in terms of clinical performance and patient-reported satisfaction to capture its multi-dimensional nature. We use a panel covering 8 years for over 8000 English general practices. We measure competition as the number of rival doctors within a small distance and control for a large number of potential confounders. We find that increases in local competition are associated with increases in patient satisfaction and to a lesser extent in clinical quality. However, the magnitude of the effect is small.

    Research areas

  • quality, healthcare, choice, competition, family physicians

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