This paper investigates how changes in hospital choice sets affect levels of patient demand for elective hospital care. We exploit a set of reforms in England that opened up the market for publicly-funded patients to private hospitals. Impacts on demand are estimated using variation in distance...

Reforms to public services have extended consumer choice by allowing for the entry of private providers. The aim is to generate competitive pressure to improve quality when consumers choose between providers. However, for many services new entrants could also affect whether a consumer demands...

Medical technological progress has been shown to be the main driver of health care costs. A key policy question is whether new treatment options are worth the additional costs. In this paper we assess the causal effect of percutaneous transluminal coronary angioplasty (PTCA), a major new heart...

New empirical evidence shows substantial heterogeneity in the altruism of healthcare providers. Spurred by this evidence, we build a spatial quality competition model with altruism heterogeneity. We find that more altruistic healthcare providers supply relatively higher quality levels and...

This article looks at the application of performance measurement systems in the health sector across OECD countries. The data comes from the 2017 OECD Survey on Performance Measurement Systems in the Health Sector and Responsibilities across Levels of Government. The results show that the...

Measuring health care productivity is important as health is a large sector of the economy and with the majority of funding coming from public sources, the outlook for productivity growth is a critical factor in the debate about fiscal sustainability. The UK has over 20 years’ experience of...

In light of the many discussions advocating the use of pay-for-performance and performance budgeting, this paper argues that discouraging experience with both approaches should temper expectations that performance measurement can be a reform that will make health care systems more "sustainable"...

A common reform used to increase consumer choice and competition in public services has been to allow private providers to compete with public incumbents. However, there remains a concern that not all consumers are able to benefit equally from wider choice. We consider the case of publicly...

Using a randomized field experiment, we show that health care specialists cream-skim patients by their expected profitability. In the German two-tier system, outpatient reimbursement rates for both public and private insurance are centrally determined but are more than twice as high for the...

The health of the world’s population - including those in the poorest countries - has improved more in the past 100 years than ever before. The improvement is largely a result of the development and spread of cheap, effective technologies (such as vaccines). Other factors, such as national...