Scandinavian Working Papers in Economics

Discussion Paper Series in Economics,
Norwegian School of Economics, Department of Economics

No 28/2018: Hospital Competition in the National Health Service: Evidence from a Patient Choice Reform

Kurt R. Brekke (), Chiara Canta (), Odd Rune Straume () and Luigi Siciliani ()
Additional contact information
Kurt R. Brekke: Dept. of Economics, Norwegian School of Economics and Business Administration, Postal: NHH , Department of Economics, Helleveien 30, N-5045 Bergen, Norway
Chiara Canta: Toulouse Business School, Postal: 1M Place Alphonse Jourdain, 31068 Toulouse, France.
Odd Rune Straume: University of Bergen, Department of Economics and University of Minho, Department of Economics/NIPE
Luigi Siciliani: University of York, Postal: Department of Economics and Related Studies, York YO10 5DD, UK

Abstract: We study the impact of exposing hospitals in a National Health Service (NHS) to non-price competition by exploiting a patient choice reform in Norway in 2001. The reform facilitates a difference-in-difference research design due to geographical variation in the scope for competition. Using rich administrative data covering the universe of NHS hospital admissions from 1998 to 2005, we find that hospitals in more competitive areas have a sharper reduction in AMI mortality, readmissions, and length of stay than hospitals in less competitive areas. These results indicate that competition improves patient health outcomes and hospital cost efficiency, even in the Norwegian NHS with large distances, low fixed treatment prices, and mainly public hospitals.

Keywords: Patient Choice; Hospital Competition; Quality; Cost-efficiency

JEL-codes: I11; I18; L13

35 pages, December 6, 2018

Full text files

2578632 PDF-file Full text

Download statistics

Questions (including download problems) about the papers in this series should be directed to Karen Reed-Larsen ()
Report other problems with accessing this service to Sune Karlsson ().

This page generated on 2024-02-05 17:12:51.