G2TT
来源类型Discussion paper
规范类型论文
来源IDDP11773
DP11773 Competition and hospital quality: Evidence from a French natural experiment
Laurent Gobillon; Carine Milcent
发表日期2017-01-12
出版年2017
语种英语
摘要We evaluate the effect of a pro-competition reform gradually introduced in France over the 2004-2008 period on hospital quality measured with the mortality of heart-attack patients. Our analysis distinguishes between hospitals depending on their status: public (university or non-teaching), non-profit or for-profit. These hospitals differ in their degree of managerial and financial autonomy as well as their reimbursement systems and incentives for competition before the reform, but they are all under a DRG-based payment system after the reform. For each hospital status, we assess the benefits of local competition in terms of decrease in mortality after the reform. We estimate a duration model for mortality stratified at the hospital level to take into account hospital unobserved heterogeneity and censorship in the duration of stays in a flexible way. Estimations are conducted using an exhaustive dataset at the patient level over the 1999-2011 period. We find that non-profit hospitals, which have managerial autonomy and no incentive for competition before the reform, enjoyed larger declines in mortality in places where there is greater competition than in less competitive markets.
主题Public Economics
关键词Competition Hospital ownership Policy evaluation Heart attack
URLhttps://cepr.org/publications/dp11773
来源智库Centre for Economic Policy Research (United Kingdom)
资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/540587
推荐引用方式
GB/T 7714
Laurent Gobillon,Carine Milcent. DP11773 Competition and hospital quality: Evidence from a French natural experiment. 2017.
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