Does Quality Affect Patients’ Choice of Doctor? Evidence from England

Abstract

Reforms giving users of public services choice of provider aim to improve quality. But such reforms will work only if quality affects choice of provider. We test this crucial prerequisite in the English health care market by examining the choice of 3.4 million individuals of family doctor. Family doctor practices provide primary care and control access to non‐emergency hospital care, the quality of their clinical care is measured and published and care is free. In this setting, clinical quality should affect choice. We find that a 1 standard deviation increase in clinical quality would increase practice size by around 17%.

Does Competition Have an Effect on Price and Quality in Physiotherapy?

“…For patient choice to act as an effective driver of quality, it is necessary to rely upon a patient's judgement and responsiveness to the quality of the service and for providers to react to the choices stemming from those judgements. Even though information about the quality of health care is quite often technical in nature and most patients have difficulties in dealing with this kind of knowledge, the performance of service providers seemingly improves when information about quality is published (Le Grand, ; Santos et al, ).…”

Free to Choose? Reform, Choice, and Consideration Sets in the English National Health Service

“…In the period we examine, PCTs also oversaw the GP practices in their area, monitoring their prescribing, inspecting their premises, providing financial assistance for practice computing, financing community nurses to complement GP services and providing information to practices to allow them to compare their performance with other practices in the PCT. On average each PCT had around 20 or so GP practices in their area (Santos, Gravelle and Propper 2015).…”

Spatial Limited Dependent Variable Models: A Review Focused on Specification, Estimation, and Health Economics Applications

“…As already said, most of them required the use of LDV or DC models to describe health care expenditures, treatment effects analysis, and many others, see, for example, Varin and Czado (), Munkin and Trivedi (), Santos et al . (), Varkevisser et al . (), Lindeboom and Kerkhofs (), Deb et al .…”

“…6 In the last 20 years, we have had an increased experience in econometric studies as the basis for health policy. As already said, most of them required the use of LDV or DC models to describe health care expenditures, treatment effects analysis, and many others, see, for example, Varin and Czado (2009), Munkin and Trivedi (2008), Santos et al (2017), Varkevisser et al (2012), Kerkhofs (2009), Deb et al (2006), and Basu et al (2007). However, a very limited number of papers take into account space and spatial structure of discrete health data sets.…”