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Recent substantive reforms to the English National Health Service expanded patient choice and encouraged hospitals to compete within a market with fixed prices. This study investigates whether these reforms led to improvements in hospital quality. We use a difference-in-difference-style estimator to test whether hospital quality (measured using mortality(More)
We use insurance claims data for 27.6 percent of individuals with private employer-sponsored insurance in the US between 2007 and 2011 to examine the variation in health spending and in hospitals’ transaction prices. We document the variation in hospital prices within and across geographic areas, examine how hospital prices influence the variation in health(More)
This paper uses a difference-in-difference estimator to test whether the introduction of patient choice and hospital competition in the English NHS in January 2006 has prompted hospitals to become more efficient. Efficiency was measured using hospitals’ average length of stay (LOS) for patients undergoing elective hip replacement. LOS was broken down into(More)
BACKGROUND Mortality rates after aortic valve replacement have declined, but little is known about the risk of hospitalization among survivors and how that has changed with time. METHODS Among Medicare patients who underwent aortic valve replacement from 1999 to 2010 and survived to 1 year, we assessed trends in 1-year hospitalization rates, mean(More)
n engl j med 375;20 nejm.org November 17, 2016 This policy did not overcome long odds in the legislature, and similar policies might not succeed in other states without federal financial participation, which is currently illegal. Any state policy action on this front will take place in the face of an uncertain future for providing undocumented immigrants(More)
This paper examines whether or not hospital competition in a market with fixed reimbursement prices can prompt improvements in clinical quality. In January 2006, the British government introduced a major extension of their market-based reforms to the English National Health Service. From January 2006 onwards, every patient in England could choose their(More)
The first finding contradicts many previously held assertions that conclusions based on analyses of readily available Medicare data can be extrapolated to private sector health care markets, for which data have generally been less accessible. As such, it is arguably more interesting and newsworthy than the second empirical finding, which is consistent with(More)
This paper uses a difference-in-difference style estimation strategy to test separately the impact of competition from public sector and private sector hospitals on the efficiency of public hospitals. Our identification strategy takes advantage of the phased introduction of a recent set of substantive reforms introduced in the English NHS from 2006 onwards.(More)