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    Divided by choice? Private providers, patient choice and hospital sorting in the English National Health Service

    Beckert, Walter (2021) Divided by choice? Private providers, patient choice and hospital sorting in the English National Health Service. Health Economics , ISSN 1099-1050. (In Press)

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    Abstract

    This paper studies patient choice of provider following government reforms in the 2000s, which allowed for-profit surgical centers to compete with existing public National Health Service (NHS) hospitals in England. For-profit providers offer significant benefits, notably shorter waiting times. We estimate the extent to which different types of patients benefit from the reforms, and we investigate mechanisms that cause differential benefits. Our counterfactual simulations show that, in terms of the value of access, entry of for-profit providers benefitted the richest patients twice as much as the poorest, and white patients six times as much as ethnic minority patients. Half of these differences is explained by healthcare geography and patient health, while primary care referral practice plays a lesser, though non-negligible role. We also show that, with capitated reimbursement, different compositions of patient risks between for-profit surgical centers and existing public hospitals put public hospitals at a competitive disadvantage.

    Metadata

    Item Type: Article
    Additional Information: This is the peer reviewed version of the article, which has been published in final form at the link above. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
    Keyword(s) / Subject(s): Patient choice, demand for healthcare, contracting out public services, in- equality
    School: School of Business, Economics & Informatics > Economics, Mathematics and Statistics
    Research Centres and Institutes: Commodities Finance Centre
    Depositing User: Administrator
    Date Deposited: 04 Jan 2021 14:16
    Last Modified: 01 Jul 2021 15:25
    URI: https://eprints.bbk.ac.uk/id/eprint/42468

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