We investigate the effect on the quality of three high-volume non-emergency treatments of a reform that relaxed restrictions on patient choice of hospital. We employ a quasi difference-in-difference strategy and use control functions allowing for patient selection into providers correlated with unobserved morbidity. Public hospitals facing more rivals reduced quality, increased waiting times, and reduced length of stay for hip and knee replacements. This is likely due to regulated prices implying larger losses on these treatments compared to coronary artery bypass grafts, where no effects were found. Our findings are robust to estimation methods and competition measures, allowing for private providers’ entry.

中文翻译：

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英国 NHS 非急诊患者的医院竞争和质量

我们调查了一项放松对患者选择医院的限制的改革对三种大容量非紧急治疗质量的影响。我们采用准差异策略并使用控制功能，允许患者选择与未观察到的发病率相关的提供者。面临更多竞争对手的公立医院降低了质量，增加了等待时间，并缩短了髋关节和膝关节置换术的住院时间。这可能是由于受监管的价格意味着与冠状动脉旁路移植术相比，这些治疗的损失更大，而冠状动脉旁路移植术没有发现任何影响。我们的研究结果对估计方法和竞争措施是可靠的，允许私人供应商进入。