Competition and equity in health care markets

Detalhes bibliográficos
Autor(a) principal: Siciliani, Luigi
Data de Publicação: 2019
Outros Autores: Straume, Odd Rune
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://hdl.handle.net/1822/65677
Resumo: We provide a model where hospitals compete on quality under fixed prices to investigate how hospital competition affects (i) quality differences between hospitals, and as a result, (ii) health inequalities across hospitals and patient severities. The answer to the first question is ambiguous and depends on factors related to both demand and supply of health care. Whether competition increases or reduces health inequalities depends on the type and measure of inequality. Health inequalities due to the postcode lottery are more likely to decrease if the marginal health gains from quality decrease at a higher rate, whereas health inequalities between high- and low-severity patients decrease if patient composition effects are sufficiently small. We also investigate the effect of competition on health inequalities as measured by the Gini and the Generalised Gini coefficients, and highlight differences compared to the simpler dispersion measures. (C) 2018 Elsevier B.V. All rights reserved.
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spelling Competition and equity in health care marketsHospital competitionQualityHealth inequalitiesGini coefficientCiências Sociais::Economia e GestãoSocial SciencesScience & TechnologyWe provide a model where hospitals compete on quality under fixed prices to investigate how hospital competition affects (i) quality differences between hospitals, and as a result, (ii) health inequalities across hospitals and patient severities. The answer to the first question is ambiguous and depends on factors related to both demand and supply of health care. Whether competition increases or reduces health inequalities depends on the type and measure of inequality. Health inequalities due to the postcode lottery are more likely to decrease if the marginal health gains from quality decrease at a higher rate, whereas health inequalities between high- and low-severity patients decrease if patient composition effects are sufficiently small. We also investigate the effect of competition on health inequalities as measured by the Gini and the Generalised Gini coefficients, and highlight differences compared to the simpler dispersion measures. (C) 2018 Elsevier B.V. All rights reserved.- We thank two anonymous reviewers for very helpful suggestions. Odd Rune Straume acknowledges funding from COMPETE (ref. no. POCI-01-0145-FEDER-006683), with the FCT/MEC's (Fundacao para a Ciencia e a Tecnologia, I.P.) financial support through national funding and by the ERDF through the Operational Programme on Competitiveness and Internationalization COMPETE 2020 under the PT2020 Partnership Agreement.ElsevierUniversidade do MinhoSiciliani, LuigiStraume, Odd Rune2019-03-012019-03-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/1822/65677eng0167-62961879-164610.1016/j.jhealeco.2018.12.00230654150https://www.sciencedirect.com/science/article/pii/S0167629618301607info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-09-30T01:30:08Zoai:repositorium.sdum.uminho.pt:1822/65677Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T19:36:28.259477Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Competition and equity in health care markets
title Competition and equity in health care markets
spellingShingle Competition and equity in health care markets
Siciliani, Luigi
Hospital competition
Quality
Health inequalities
Gini coefficient
Ciências Sociais::Economia e Gestão
Social Sciences
Science & Technology
title_short Competition and equity in health care markets
title_full Competition and equity in health care markets
title_fullStr Competition and equity in health care markets
title_full_unstemmed Competition and equity in health care markets
title_sort Competition and equity in health care markets
author Siciliani, Luigi
author_facet Siciliani, Luigi
Straume, Odd Rune
author_role author
author2 Straume, Odd Rune
author2_role author
dc.contributor.none.fl_str_mv Universidade do Minho
dc.contributor.author.fl_str_mv Siciliani, Luigi
Straume, Odd Rune
dc.subject.por.fl_str_mv Hospital competition
Quality
Health inequalities
Gini coefficient
Ciências Sociais::Economia e Gestão
Social Sciences
Science & Technology
topic Hospital competition
Quality
Health inequalities
Gini coefficient
Ciências Sociais::Economia e Gestão
Social Sciences
Science & Technology
description We provide a model where hospitals compete on quality under fixed prices to investigate how hospital competition affects (i) quality differences between hospitals, and as a result, (ii) health inequalities across hospitals and patient severities. The answer to the first question is ambiguous and depends on factors related to both demand and supply of health care. Whether competition increases or reduces health inequalities depends on the type and measure of inequality. Health inequalities due to the postcode lottery are more likely to decrease if the marginal health gains from quality decrease at a higher rate, whereas health inequalities between high- and low-severity patients decrease if patient composition effects are sufficiently small. We also investigate the effect of competition on health inequalities as measured by the Gini and the Generalised Gini coefficients, and highlight differences compared to the simpler dispersion measures. (C) 2018 Elsevier B.V. All rights reserved.
publishDate 2019
dc.date.none.fl_str_mv 2019-03-01
2019-03-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://hdl.handle.net/1822/65677
url https://hdl.handle.net/1822/65677
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 0167-6296
1879-1646
10.1016/j.jhealeco.2018.12.002
30654150
https://www.sciencedirect.com/science/article/pii/S0167629618301607
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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