Association between market concentration of hospitals and patient health gain following hip replacement surgery

Title: Association between market concentration of hospitals and patient health gain following hip replacement surgery
Authors: Feng, Y
Pistollato, M
Charlesworth, A
Devlin, N
Propper, C
Sussex, J
Item Type: Journal Article
Abstract: Objectives To assess the association between market concentration of hospitals (as a proxy for competition) and patient-reported health gains after elective primary hip replacement surgery. Methods Patient Reported Outcome Measures data linked to NHS Hospital Episode Statistics in England in 2011/12 were used to analyse the association between market concentration of hospitals measured by the Herfindahl-Hirschman Index (HHI) and health gains for 337 hospitals. Results The association between market concentration and patient gain in health status measured by the change in Oxford Hip Score (OHS) after primary hip replacement surgery was not statistically significant at the 5% level both for the average patient and for those with more than average severity of hip disease (OHS worse than average). For 12,583 (49.1%) patients with an OHS before hip replacement surgery better than the mean, a one standard deviation increase in the HHI, equivalent to a reduction of about one hospital in the local market, was associated with a 0.104 decrease in patients’ self-reported improvement in OHS after surgery, but this was not statistically significant at the 5% level. Conclusions Hospital market concentration (as a proxy for competition) appears to have no significant influence (at the 5% level) on the outcome of elective primary hip replacement. The generalizability of this finding needs to be investigated.
Issue Date: 1-Jan-2015
Date of Acceptance: 1-Sep-2014
URI: http://hdl.handle.net/10044/1/76769
DOI: 10.1177/1355819614546032
ISSN: 1355-8196
Publisher: SAGE Publications
Start Page: 11
End Page: 17
Journal / Book Title: Journal of Health Services Research and Policy
Volume: 20
Issue: 1
Copyright Statement: © The Author(s) 2014. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(http://www.uk.sagepub.com/aboutus/openaccess.htm).
Sponsor/Funder: Economic & Social Research Council (ESRC)
Funder's Grant Number: ES/J023108/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Health Policy & Services
Health Care Sciences & Services
hip replacement surgery
hospital market concentration
patient reported outcome measures
OMITTED VARIABLE BIAS
PHANTOM MENACE
COMPETITION
OUTCOMES
hip replacement surgery
hospital market concentration
patient reported outcome measures
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip
Economic Competition
Elective Surgical Procedures
England
Female
Health Services Research
Health Status
Hospitals
Humans
Male
Middle Aged
Patient Satisfaction
State Medicine
Treatment Outcome
Humans
Treatment Outcome
Arthroplasty, Replacement, Hip
Health Status
Aged
Aged, 80 and over
Middle Aged
Hospitals
Economic Competition
Health Services Research
State Medicine
Patient Satisfaction
England
Female
Male
Elective Surgical Procedures
Science & Technology
Life Sciences & Biomedicine
Health Policy & Services
Health Care Sciences & Services
hip replacement surgery
hospital market concentration
patient reported outcome measures
OMITTED VARIABLE BIAS
PHANTOM MENACE
COMPETITION
OUTCOMES
Health Policy & Services
1117 Public Health and Health Services
1402 Applied Economics
Publication Status: Published
Online Publication Date: 2014-09-11
Appears in Collections:Imperial College Business School