Health spending per capita in England has more than doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending...

This paper investigates the consequences that patients face when their regular primary care provider closes down her practice, typically due to retirement. We estimate the causal impact of closures on patients' utilization patterns, medical expenditures, hospitalizations, and health plan choice....

In the last few years there has been an increasing public pressure in many countries to contain costs in the healthcare sector, leading many national governments to introduce some form of prospective payment system and to reduce the scope for global budgeting. In this paper we investigate...

This paper analyses the effects of immigration on waiting times in the National Health Service (NHS) in England. Linking administrative records from the Hospital Episode Statistics (2003-2012) with immigration data drawn from the UK Labour Force Survey, we find that immigration reduced waiting...

Excess zeros are encountered in many empirical count data applications. We provide a new explanation of extra zeros, related to the underlying stochastic process that generates events. The process has two rates, a lower rate until the first event, and a higher one thereafter. We derive the...

This paper systematizes some aspects related to the consequences of the institutional health system in the financing and delivery of health care services. The analysis is based on empirical evidences from United States, Canada and United Kingdom. The focus of this work is on the analysis of the...

There is widespread and unexplained variation in the outcomes of similar patients across place and providers in all developed health systems. This paper provides new evidence on the role senior doctors play in determining patient outcomes. I exploit within-hospital quasi-random assignment of...

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...

UK Local Authorities purchase care home places on behalf of a large group of people following a means test of their income and wealth. All other buyers of care home services are atomistic. The care home market is characterised by a large number of small providers. Local authorities may thus have...