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Publication
Quality decreases from introducing patient choice in a National Health Service
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Authors
Advisor(s)
Abstract(s)
A view often expressed about patient choice of health care providers is that it will
increase competition between providers, which benefits the efficiency of the health
system. We address here a patient choice initiative, regarding selection of hospital
for specialty consultations, in the Portuguese National Health Service (NHS) that
has two specific features. The first feature involves shared decision making between
patients and GPs, in the choice of hospital for referral, which should be based on
publicly available information on “quality”. The second specific feature is that the
patient choice initiative did not involve payment changes to NHS hospitals associated with patients’ movements. We show that explaining initial asymmetries in
qualities (waiting times) with systematic differences in hospital characteristics (cost
advantages and managerial talent) leads to potential asymmetric responses to the
introduction of patient choice in the NHS. This implies that the empirical analysis has to accommodate such asymmetries. Explicitly allowing for asymmetries in
responses to the policy measure reveals that reactions were indeed different, with
top-performance hospitals reducing their qualities (increasing waiting times) after
the patient choice initiative was introduced.
Description
Keywords
Hospital quality Patient choice
Pedagogical Context
Citation
Barros, Pedro Pita (2022). "Quality decreases from introducing patient choice in a National Health Service". Portuguese Economic Journal, 21(3):351-381
Publisher
Springer