title: Choice of hospital: Which type of quality matters?
abstract: The implications of hospital quality competition depend on what type of quality affects choice of hospital. Previous studies of quality and choice of hospitals have used crude measures of quality such as mortality and readmission rates rather than measures of the health gain from specific treatments. We estimate multinomial logit models of hospital choice by patients undergoing hip replacement surgery in the English NHS to test whether hospital demand responds to quality as measured by detailed patient reports of health before and after hip replacement. We find that a one standard deviation increase in average health gain increases demand by up to 10%. The more traditional measures of hospital quality are less important in determining hospital choice.
authors: Centre for Health Economics, University of York, York, United Kingdom. Electronic address: nils.gutacker@york.ac.uk.
authors: Nils
authors: N
authors: Gutacker
authors: Department of Economics and Related Studies, University of York, York, United Kingdom.
authors: Luigi
authors: L
authors: Siciliani
authors: Centre for Health Economics, University of York, York, United Kingdom.
authors: Giuseppe
authors: G
authors: Moscelli
authors: Centre for Health Economics, University of York, York, United Kingdom.
authors: Hugh
authors: H
authors: Gravelle
mesh_terms: D019644:Arthroplasty, Replacement, Hip; D002755:Choice Behavior; D017052:Hospital Mortality; D006761:Hospitals / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D011787:Quality of Health Care; D013222:State Medicine
keywords: Competition; Demand; Healthcare; Hospitals; Patient reported outcomes; Quality