We examine whether a hospitals quality is affected by the quality provided by other hospitals in the same market. We first set out a theoretical model with regulated prices which specifies conditions on demand and cost functions which determine whether a hospital will have higher quality when...

The relationship between the quality of health care and the extent of competition amongst providers has been the subject of intense policy interest and debate. As part of the ESHCRU programme we are undertaking a set of related investigations into this relationship in the hospital sector, in...

Expenditure on long term care is expected to rise, driven by an ageing population. Coordination between health and long term care is increasingly a priority for policymakers. Elderly individuals living at home who suffer trauma, such as hip fracture or stroke, generally require immediate acute...

Recent and planned policy changes in the NHS, including the abolition of the Medical Practices Committee, revised tendering arrangements for new practices, readily available information on practices via NHS Choices, and letting patients register with any practice, will increase potential...

Hospital bed blocking occurs when hospital patients are ready to be discharged to a nursing home but no place is available, so that hospital care acts as a more costly substitute for long-term care. We investigate the extent to which higher supply of nursing home beds or lower prices can reduce...

We examine whether a hospital's quality is affected by the quality provided by other hospitals in the same market. We first sketch a theoretical model with regulated prices and derive conditions on demand and cost functions which determine whether a hospital will increase its quality if its...

The English NHS has introduced a system of budgets for general practices covering hospital expenditure for the patients on their lists. We model individual expenditure using diagnostic information from previous hospital spells, plus a large set of attributed variables measuring population,...

We examine how public sector third-party purchasers and hospitals negotiate quality targets when a fixed proportion of hospital revenue is required to be linked to quality. We develop a bargaining model linking the number of quality targets to purchaser and hospital characteristics. Using data...

We investigate the impact of area general practitioner (GP) supply on individual health in England. If no allowance is made for the endogeneity of GP supply, the effect is positive but not statistically significant. When GP supply is instrumented by age related capitation the effect is markedly...

Since 2003, 25% of UK general practitioners’ income has been determined by the quality of their care. The 65 clinical quality indicators in this scheme (the Quality and Outcomes Framework) are in the form of ratios, with financial reward increasing linearly with the ratio between a lower and...