Market Structure, Patient Choice and Hospital Quality for Elective Patients (with G Moscelli and H Gravelle)

Date: 8^th March at 12h

Room: 24.009 (Mercè Rodoreda Building) – Universitat Pompeu Fabra

Abstract: We examine the change in the effect of market structure on hospital quality for elective procedures (hip and knee replacements, and coronary artery bypass grafts) following the 2006 loosening of restrictions on patient choice of hospital in England. We allow for time-varying endogeneity due to the effect of unobserved patient characteristics on patient choice of hospital using Two Stage Residual Inclusion. We find that the change in the effect of market structure due to the 2006 choice reforms was to reduce quality by increasing the probability of a post-operative emergency readmission for hip and knee replacement patients. There was no effect of the choice reform on hospital quality for coronary bypass patients. We find no evidence of self-selection of patients into hospitals, suggesting that a rich set of patient-level covariates controls for differences in casemix.

Biography

Luigi Siciliani is a Professor of Health Economics at the Department of Economics and Related Studies at the University of York, where he directs the MSc in Health Economics. He is a co-Editor of the Journal of Health Economics since 2008. He is affiliated with the Centre for Health Economics and co-directs the competition stream of the Economics of Health and Social Care Research Unit. Prior to this he worked for the OECD in 2000-01 under the first OECD waiting time project. He has specialised in the economics of hospitals and has published over 40 articles in peer-reviewed journals. His research interests include waiting times for elective care, hospital quality competition, contracting theory applied to health care, pay for performance and coordination between health and social care.

https://pure.york.ac.uk/portal/en/researchers/luigi-siciliani(f516be4f-d90f-49f0-9092-73293f590808).html