The implications of hospital quality competition depend on what type affects choice hospital. Previous studies and hospitals have used crude measures such as mortality readmission rates rather than the health gain from specific treatments. We estimate multinomial logit models by patients undergoing hip replacement surgery in English NHS to test whether demand responds measured detailed patient reports before after replacement. find that a one standard deviation increase average increases up...

Equity of access is a key policy objective in publicly-funded healthcare systems. However, observed inequalities by socioeconomic status may result from differences patients’ choices. Using data on non-emergency coronary revascularisation procedures the English National Health Service, we found substantive waiting times within public hospitals between patients with different status: up to 35% difference, or 43 days, most and least deprived population quintile groups. selection models...

Retention of skilled workers is essential for labour-intensive organisations like hospitals, where an excessive turnover doctors and nurses can reduce the quality quantity services to patients. In public sector, salaries are often not negotiable at individual level, increasingly care about non-pecuniary aspects their jobs. We empirically investigate role played by two such aspects, staff engagement retention complementary coworkers, in affecting employee within hospital sector. exploit a...

We investigate (a) how patient choice of hospital for elective hip replacement is influenced by distance, quality and waiting times, (b) differences in choices between patients urban rural locations, (c) the relationship hospitals' elasticities demand to number local rivals, these changed after relaxation constraints on England 2006. Using a data set over 500,000 period 2002 2013 we find that became more likely travel provider with higher or lower proportion bypassing their nearest increased...

Excessive turnover reduces the stock of an organization's human capital. In public sector, where wage increases are often constrained, managers need to leverage non-monetary working conditions retain their workers. We investigate whether workers responsive improvements in non-wage aspects job by evaluating impact on nurse retention a programme that encouraged hospitals increase staff through data monitoring and improving non-pecuniary nursing jobs. Employing rich employee-level...

To investigate the association between monthly turnover rates of hospital nurses and senior doctors patient health outcomes (mortality unplanned readmissions).

Abstract We investigate the effect on quality of three high‐volume non‐emergency treatments a reform that relaxed restrictions patient choice hospital. employ quasi difference‐in‐difference strategy and use control functions allowing for selection into providers correlated with unobserved morbidity. Public hospitals facing more rivals reduced quality, increased waiting times, length stay hip knee replacements. This is likely due to regulated prices implying larger losses these compared...

Abstract We use the 2006 relaxation of constraints on patient choice hospital in English NHS to investigate effect competition dimensions efficiency including indicators resource management (admissions per bed, bed occupancy rate, proportion day cases, and cancelled elective operations) costs (reference cost index for overall activity, cleaning services costs, laundry linen costs). employ a quasi differences‐in‐differences approach estimate seemingly unrelated regressions unconditional...

Abstract We investigate how exogenous variation in daylight caused by Daylight Saving Time affects road safety as measured the count of vehicle crashes. use administrative daily data from Greece covering universe all types recorded accidents during 2006–2016 period. Our regression discontinuity estimates support an ambient light mechanism that reduces counts serious Spring transition and increases minor ones Fall transition. The effects are driven hour intervals mostly affected seasonal...

Abstract Retention of skilled workers is essential for labour‐intensive organizations like hospitals, where an excessive turnover doctors and nurses can reduce the quality quantity services provided to patients. Exploiting a unique rich panel dataset based on employee‐level payroll staff survey records from universe English NHS we investigate empirically role played by two non‐pecuniary job factors, engagement retention complementary co‐workers, in affecting employee within public hospital...

Excessive turnover can signicantly impair an organization's performance. Using high-quality administrative data and staggered dierence-in-dierences strategies, we evaluate the impact of a programme that encouraged public hospitals to increase staff retention by providing guidelines on how improve non-pecuniary aspects nursing jobs. We find has decreased nurse rate 4.49%, exits from hospital sector 5.38%, reduced mortality within 30 days admission 3.45%, preventing 11,400 deaths. Our results...

Abstract Reimbursement of English mental health hospitals is moving away from block contracts and towards activity outcome‐based payments. Under the new model, patients are categorised into 20 groups with similar levels need, called clusters , to which prices may be assigned prospectively. Clinicians, who make clustering decisions, have substantial discretion can, in principle, directly influence level reimbursement hospital receives. This create incentives for upcoding. Clinicians supported...

Although it is commonly understood that light conditions affect driving behavior, detailed evidence scarce especially for EU countries. In this paper we use the exogenous variation in daylight caused by Daylight Saving Time (DST) shifts to examine role of on vehicle accidents. We a rich data-set from Greek administrative data covering universe all types recorded accidents over period between 01 January 2006 32 December 2016. Relying regression discontinuity design attempt provide casual...

We investigate the extent to which small hospitals are associated with lower quality. first take a patient perspective, and test if, controlling for casemix, patients admitted receive quality than those larger hospitals. then if differences in between large can be explained by hospital characteristics such as type staffing. use range of measures including mortality rates (overall specific conditions), acquired infection rates, waiting times emergency patients, perceptions care they receive....

We use a quasi difference-in-difference approach to examine whether the 2006 relaxation of constraints on patient choice hospital in English National Health Service (NHS) affected waiting times inequalities for three common elective treatments (coronary bypass, hip replacement and knee replacement) hospitals which faced more potential competition (number rivals) before reform was introduced relative those less competition. After had rivals longer waits replacement, with one additional rival...