Free to choose? Reform, choice, and consideration sets in the English National Health Service

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Title: Free to choose? Reform, choice, and consideration sets in the English National Health Service
Author(s): Gaynor, M
Propper, C
Seiler, S
Item Type: Journal Article
Abstract: Choice in public services is controversial. We exploit a reform in the English National Health Service to assess the effect of removing constraints on patient choice. We estimate a demand model that explicitly captures the removal of the choice constraints imposed on patients. We find that, post-removal, patients became more responsive to clinical quality. This led to a modest reduction in mortality and a substantial increase in patient welfare. The elasticity of demand faced by hospitals increased substantially post-reform and we find evidence that hospitals responded to the enhanced incentives by improving quality. This suggests greater choice can raise quality.
Publication Date: 1-Nov-2016
Date of Acceptance: 6-May-2016
URI: http://hdl.handle.net/10044/1/32626
DOI: https://dx.doi.org/10.1257/aer.20121532
ISSN: 0002-8282
Publisher: American Economic Association
Start Page: 3521
End Page: 3557
Journal / Book Title: American Economic Review
Volume: 106
Issue: 11
Copyright Statement: © 2016 by the American Economic Association. Permission to make digital or hard copies of part or all of American Economic Association publications for personal or classroom use is granted without fee provided that copies are not distributed for profit or direct commercial advantage and that copies show this notice on the first page or initial screen of a display along with the full citation, including the name of the author. Copyrights for components of this work owned by others than AEA must be honored. Abstracting with credit is permitted.
Sponsor/Funder: Department of Health
Economic & Social Research Council (ESRC)
Funder's Grant Number: PO Number: CMPO057
ES/J023108/1
Keywords: Demand Estimation
Non-price Competition
Health Economics
Patient Choice
Health Care Reform
14 Economics
15 Commerce, Management, Tourism And Services
Economics
Publication Status: Published
Appears in Collections:Imperial College Business School



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