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...

This paper analyzes the impact of service quality on patients' satisfaction with the Portuguese National Health Service, through a novel indicator the Index of Satisfaction with the NHS that measures the share of children delivered in the NHS hospitals to total number of children delivered, in...

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...

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...

2018 marks the 70th birthday of the UK National Health Service – an institution which commands an unparalleled trust and reverence from the British people.1 Yet, to many casual onlookers, the Health Service appears to be in a perpetual state of “crisis”. To some extent, this is borne out...

Despite some relative improvements in the last fifteen years, the National Health Service remains an international laggard in terms of those health outcomes that can be attributed to the healthcare system. In international comparisons of health system performance, the NHS almost always ranks in...

We explore whether NHS hospitals managed their earnings upward before applying for Foundation Trust (FT) status, a scheme that allowed them greater financial freedom and management autonomy, in order to present an overly positive picture and increase their chances for a successful application....

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...

We develop a general framework for optimal health policy design in a dynamic setting. We consider a hypothetical medical intervention for a cohort of patients where one parameter varies across cohorts with imperfectly observable linear dynamics. We seek to identify the optimal time to change the...