Cookson, Richard Andrew orcid.org/0000-0003-0052-996X, Laudicella, Mauro and Li Donni, Paolo (2011) Does hospital competition harm equity? Evidence from the English National Health Service. Discussion Paper. CHE Research Paper . Centre for Health Economics, University of York , York, UK.
Abstract
Increasing evidence shows that hospital competition under fixed prices can improve quality and reduce cost. Concerns remain, however, that competition may undermine socio-economic equity in the utilisation of care. We test this hypothesis in the context of the pro-competition reforms of the English National Health Service progressively introduced from 2004 to 2006. We use a panel of 32,482 English small areas followed from 2003 to 2008 and a difference in differences approach. The effect of competition on equity is identified by the interaction between market structure, small area income deprivation and year. We find a negative association between market dispersion and elective admissions in deprived areas. The effect of pro-competition reform was to reduce this negative association slightly, suggesting that competition did not undermine equity.
Metadata
Authors/Creators: |
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Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) > CHE Research Papers (York) |
Depositing User: | Pure (York) |
Date Deposited: | 17 Oct 2018 09:50 |
Last Modified: | 06 Dec 2023 15:28 |
Status: | Published |
Publisher: | Centre for Health Economics, University of York |
Series Name: | CHE Research Paper |
Refereed: | No |
Related URLs: |
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