Free to Choose? Reform, Choice, and Consideration Sets in the English National Health Service
Free to Choose? Reform, Choice, and Consideration Sets in the English National Health Service
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DOI：
10.1257/aer.20121532
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发表时间：
2016-11-01
影响因子：
10.7
通讯作者：
Seiler, Stephan
中科院分区：
文献类型：
--
作者：
Gaynor, Martin;Propper, Carol;Seiler, Stephan
公共服务的选择是有争议的。我们利用英国国家医疗服务体系的一项改革来评估取消对患者选择的限制的效果。我们估计了一个需求模型，该模型明确地捕捉到了对患者施加的选择限制的消除。我们发现，摘除后，患者对临床质量的反应更强。这导致了死亡率的适度下降和患者福利的大幅增加。医院面临的需求弹性在改革后大幅增加，我们发现有证据表明，医院通过提高质量来回应增强的激励。这表明，更多的选择可以提高质量。
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.