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The Impact of Hospital Competition on Maternity Care in the English Hospital Market

Yıl 2018, Cilt: 16 Sayı: 32, 451 - 470, 29.11.2018

Öz

Abstract

 





The policies
focusing on the improvements in the quality of health care services have become
very popular in recent years. One of the main government policies which can
improve quality in health care can be considered as hospital competition. In
this paper, I examine whether, hospital competition can improve the quality
indicators for maternity care. I investigate whether increasing competition
among NHS (National Health Service) hospitals can lead to any improvements in
rate of 28 days of emergency readmissions, baby’s mortality, rate of elective
c-sections and rates of birth complications at hospital level after 2010 for
England by exploiting a suitable econometric setting (difference in differences
design).  According to the weighted fixed
effects regression, there is some evidence of a reduction in emergency
readmissions rate within 28 days of discharge (1 unit increase in market
concentration measure reduces emergency readmission rate within 28 days of
discharge by almost 0.0004 admissions (per 1000 admissions). 

Kaynakça

  • Brekke, B. R., Siciliani, L. and Straume, L., ‘Hospital Competition and Quality with Regulated Prices. The Scandinavian Journal of Economics’, Vol. 113(2), 2011, pp. 444–469.
  • Burgess, S., Propper, C. and Gossage, D., ‘Competition and Quality: Evidence from the NHS Internal Market 1991 – 1996’, The Economic Journal, Vol. 118, 2008, pp. 138-170.
  • Cooper Zack, Stephen Gibbons, Simon Jones, and Alistair McGuire, ‘Does hospital competition save lives? Evidence from the English NHS Patient Choice Reforms’, LSE Health Working Paper, 2010,16/2010.
  • Department of Health, ‘Maternity Matters: choice, access and continuity of care in a safe service’, 2007, [Accessed 10th June 2018]. Available from: http://webarchive.nationalarchives.gov.uk/20130103035958/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_074199.pdf .
  • Dixon, A., Robertson, R., Appleby, J., Burge, P. et al., ‘How Patients Choose and How Providers Respond’, 2010, [Accessed 10 June 2018]. Available from: http://www.kingsfund.org.uk/sites/files/kf/Patient-choice-final-report-Kings-Fund-Anna_Dixon-Ruth-Robertson-John-Appleby-Peter-Purge-Nancy-Devlin-Helen-Magee-June-2010.pdf .
  • Ertok, M., ‘Evaluation of a Pay for Performance Scheme in Maternity Care: The Commissioning Quality and Innovation Payment Framework in England’, Procedia - Social and Behavioral Sciences, Vol. 195, 2015, pp. 93-102.
  • Feng, Y., Pistollato, M., Propper, C. et al., ‘Association between market concentration of hospitals and patient health gain following hip replacement surgery’, Journal of Health Services Research and Policy, [Accessed 27th November 2014], available from: http://hsr.sagepub.com/content/early/2014/09/08/1355819614546032 .
  • Gaynor, M., ‘Competition and quality in healthcare markets’, Foundations and Trends in Microeconomics, Vol.2(6), 2006, pp. 441-508.
  • Kessler, D.P. and Geppert, J.J., ‘The effects of competition on variation in the quality and cost of medical care’, Journal of Economics and Management Strategy, Vol. 14, 2005, pp. 575-589.
  • Kessler, D.P. and McClellan, M., ‘Is hospital competition socially wasteful?’, Quarterly Journal of Economics. Vol.115(2),2000, pp. 577–615.
  • Mukamel, D., Zwanziger, J., Tomaszewski, K.J., ‘HMO penetration, competition and risk-adjusted hospital mortality’, Health Services Research, Vol. 36, 2001, pp. 1019-1035.
  • National Institute for Health and Care Excellence website, Caesarean section, 2011, [Accessed 21st October 2014]. Available from: http://www.nice.org.uk/guidance/cg132 .
  • Nuscheler, R., ‘Physician reimbursement, time consistency, and the quality of care’, Journal of Institutional and Theoretical Economics, Vol. 159(2), 2003, pp. 302-322.
  • Office for National Statistics. Super Output Areas. 2001 Census. [Accessed 1st October 2014]. Available from:http://www.ons.gov.uk/ons/guide-method/geography/beginner-s-guide/census/super-output-areas--soas-/index.html .
  • Propper, C., Gaynor, M. and Moreno-Serra, R., ‘Death by market power: reform, competition and patient outcomes in the National Health Service’, American Economic Journal: Economic Policy, Vol. 5(4), 2013, pp. 134-166.
  • Tay, A., ‘Assessing competition in hospital care markets: the importance of accounting for quality differentiation’, RAND Journal of Economics, Vol. 34, 2003, pp. 786-814.
  • Wong, H.S., Zhan, C. and Mutter, R., ‘Do Different Measures of Hospital Competition Matter in Empirical Investigations of Hospital Behavior?’, Review of Industrial Organization, Vol. 26, 2005, pp. 61-87.
  • Wooldridge, J.M., Introductory Econometrics, 4th edition, (USA: South Western Cangage Learning, 2009).
  • Propper, C. Gaynor, M., Dixon, J. et al., ‘The final Report of competition under fixed prices’, Department of Health Policy Research Programme Project Reference number 0160108. [Accessed 8th October 2017]. Available from: http://hrep.lshtm.ac.uk/publications/Technical_notes_I_II_propper.pdf .
Yıl 2018, Cilt: 16 Sayı: 32, 451 - 470, 29.11.2018

Öz

Kaynakça

  • Brekke, B. R., Siciliani, L. and Straume, L., ‘Hospital Competition and Quality with Regulated Prices. The Scandinavian Journal of Economics’, Vol. 113(2), 2011, pp. 444–469.
  • Burgess, S., Propper, C. and Gossage, D., ‘Competition and Quality: Evidence from the NHS Internal Market 1991 – 1996’, The Economic Journal, Vol. 118, 2008, pp. 138-170.
  • Cooper Zack, Stephen Gibbons, Simon Jones, and Alistair McGuire, ‘Does hospital competition save lives? Evidence from the English NHS Patient Choice Reforms’, LSE Health Working Paper, 2010,16/2010.
  • Department of Health, ‘Maternity Matters: choice, access and continuity of care in a safe service’, 2007, [Accessed 10th June 2018]. Available from: http://webarchive.nationalarchives.gov.uk/20130103035958/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_074199.pdf .
  • Dixon, A., Robertson, R., Appleby, J., Burge, P. et al., ‘How Patients Choose and How Providers Respond’, 2010, [Accessed 10 June 2018]. Available from: http://www.kingsfund.org.uk/sites/files/kf/Patient-choice-final-report-Kings-Fund-Anna_Dixon-Ruth-Robertson-John-Appleby-Peter-Purge-Nancy-Devlin-Helen-Magee-June-2010.pdf .
  • Ertok, M., ‘Evaluation of a Pay for Performance Scheme in Maternity Care: The Commissioning Quality and Innovation Payment Framework in England’, Procedia - Social and Behavioral Sciences, Vol. 195, 2015, pp. 93-102.
  • Feng, Y., Pistollato, M., Propper, C. et al., ‘Association between market concentration of hospitals and patient health gain following hip replacement surgery’, Journal of Health Services Research and Policy, [Accessed 27th November 2014], available from: http://hsr.sagepub.com/content/early/2014/09/08/1355819614546032 .
  • Gaynor, M., ‘Competition and quality in healthcare markets’, Foundations and Trends in Microeconomics, Vol.2(6), 2006, pp. 441-508.
  • Kessler, D.P. and Geppert, J.J., ‘The effects of competition on variation in the quality and cost of medical care’, Journal of Economics and Management Strategy, Vol. 14, 2005, pp. 575-589.
  • Kessler, D.P. and McClellan, M., ‘Is hospital competition socially wasteful?’, Quarterly Journal of Economics. Vol.115(2),2000, pp. 577–615.
  • Mukamel, D., Zwanziger, J., Tomaszewski, K.J., ‘HMO penetration, competition and risk-adjusted hospital mortality’, Health Services Research, Vol. 36, 2001, pp. 1019-1035.
  • National Institute for Health and Care Excellence website, Caesarean section, 2011, [Accessed 21st October 2014]. Available from: http://www.nice.org.uk/guidance/cg132 .
  • Nuscheler, R., ‘Physician reimbursement, time consistency, and the quality of care’, Journal of Institutional and Theoretical Economics, Vol. 159(2), 2003, pp. 302-322.
  • Office for National Statistics. Super Output Areas. 2001 Census. [Accessed 1st October 2014]. Available from:http://www.ons.gov.uk/ons/guide-method/geography/beginner-s-guide/census/super-output-areas--soas-/index.html .
  • Propper, C., Gaynor, M. and Moreno-Serra, R., ‘Death by market power: reform, competition and patient outcomes in the National Health Service’, American Economic Journal: Economic Policy, Vol. 5(4), 2013, pp. 134-166.
  • Tay, A., ‘Assessing competition in hospital care markets: the importance of accounting for quality differentiation’, RAND Journal of Economics, Vol. 34, 2003, pp. 786-814.
  • Wong, H.S., Zhan, C. and Mutter, R., ‘Do Different Measures of Hospital Competition Matter in Empirical Investigations of Hospital Behavior?’, Review of Industrial Organization, Vol. 26, 2005, pp. 61-87.
  • Wooldridge, J.M., Introductory Econometrics, 4th edition, (USA: South Western Cangage Learning, 2009).
  • Propper, C. Gaynor, M., Dixon, J. et al., ‘The final Report of competition under fixed prices’, Department of Health Policy Research Programme Project Reference number 0160108. [Accessed 8th October 2017]. Available from: http://hrep.lshtm.ac.uk/publications/Technical_notes_I_II_propper.pdf .
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Merve Ertok Onurlu

Yayımlanma Tarihi 29 Kasım 2018
Gönderilme Tarihi 12 Haziran 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 16 Sayı: 32

Kaynak Göster

APA Ertok Onurlu, M. (2018). The Impact of Hospital Competition on Maternity Care in the English Hospital Market. Yönetim Bilimleri Dergisi, 16(32), 451-470.

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