Competition and Equity in Health Care Markets
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://hdl.handle.net/1822/60226 |
Resumo: | We provide a model where hospitals compete on quality under a fixed price regime to investigate (i) whether hospital competition, as measured by an increase in fixed prices or increased patient choice, increases or reduces the gap in quality between high- and low-quality hospitals, and as a result, (ii) whether competition increases or reduces (pure) health inequalities across hospitals and patient severities. The answer to the first question is generally ambiguous, but we find that the scope for competition to result in quality convergence across hospitals is larger when the marginal patient health gains from quality decrease at a faster rate. Whether competition increases health inequalities depends on the type and measure of inequality. If the patient health benet function is not too concave in quality, health inequalities due to postcode lottery will increase (decrease) whenever competition induces quality dispersion (convergence). Competition reduces health inequalities between high- and low-severity patients if patient composition effects, due to high-severity patients being more likely to exercise choice, are small. We also investigate the effect of competition on health inequalities as measured by the Gini and the Generalised Gini coe¢ cients, and highlight differences compared to the simpler dispersion measures. |
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Competition and Equity in Health Care MarketsHospital competitionQualityHealth inequalitiesGini coefficientCiências Sociais::Economia e GestãoWe provide a model where hospitals compete on quality under a fixed price regime to investigate (i) whether hospital competition, as measured by an increase in fixed prices or increased patient choice, increases or reduces the gap in quality between high- and low-quality hospitals, and as a result, (ii) whether competition increases or reduces (pure) health inequalities across hospitals and patient severities. The answer to the first question is generally ambiguous, but we find that the scope for competition to result in quality convergence across hospitals is larger when the marginal patient health gains from quality decrease at a faster rate. Whether competition increases health inequalities depends on the type and measure of inequality. If the patient health benet function is not too concave in quality, health inequalities due to postcode lottery will increase (decrease) whenever competition induces quality dispersion (convergence). Competition reduces health inequalities between high- and low-severity patients if patient composition effects, due to high-severity patients being more likely to exercise choice, are small. We also investigate the effect of competition on health inequalities as measured by the Gini and the Generalised Gini coe¢ cients, and highlight differences compared to the simpler dispersion measures.Fundação para a Ciência e Tecnologia (FCT)info:eu-repo/semantics/publishedVersionUniversidade do Minho. Núcleo de Investigação em Políticas Económicas (NIPE)Universidade do MinhoSiciliani, LuigiStraume, Odd Rune20182018-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/1822/60226enghttps://www.eeg.uminho.pt/pt/investigar/nipe/Paginas/publicacoes.aspxinfo: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:RCAAP2023-07-21T12:07:15Zoai:repositorium.sdum.uminho.pt:1822/60226Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:58:08.865753Repositório 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 |
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 |
topic |
Hospital competition Quality Health inequalities Gini coefficient Ciências Sociais::Economia e Gestão |
description |
We provide a model where hospitals compete on quality under a fixed price regime to investigate (i) whether hospital competition, as measured by an increase in fixed prices or increased patient choice, increases or reduces the gap in quality between high- and low-quality hospitals, and as a result, (ii) whether competition increases or reduces (pure) health inequalities across hospitals and patient severities. The answer to the first question is generally ambiguous, but we find that the scope for competition to result in quality convergence across hospitals is larger when the marginal patient health gains from quality decrease at a faster rate. Whether competition increases health inequalities depends on the type and measure of inequality. If the patient health benet function is not too concave in quality, health inequalities due to postcode lottery will increase (decrease) whenever competition induces quality dispersion (convergence). Competition reduces health inequalities between high- and low-severity patients if patient composition effects, due to high-severity patients being more likely to exercise choice, are small. We also investigate the effect of competition on health inequalities as measured by the Gini and the Generalised Gini coe¢ cients, and highlight differences compared to the simpler dispersion measures. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018 2018-01-01T00:00:00Z |
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/1822/60226 |
url |
https://hdl.handle.net/1822/60226 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.eeg.uminho.pt/pt/investigar/nipe/Paginas/publicacoes.aspx |
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 |
Universidade do Minho. Núcleo de Investigação em Políticas Económicas (NIPE) |
publisher.none.fl_str_mv |
Universidade do Minho. Núcleo de Investigação em Políticas Económicas (NIPE) |
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 |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799132371247693824 |