Working Paper: CEPR ID: DP12917
Authors: Hugh S. Gravelle; Dan Liu; Carol Propper; Rita Santos
Abstract: We examine whether family doctor firms in England respond to local competition by increasing their quality. We measure quality in terms of clinical performance and patient-reported satisfaction to capture its multi-dimensional nature. We use a panel covering 8 years for over 8000 English general practices, allowing us to control for unobserved local area effects. We measure competition by the number of rival doctors within a small distance. We find that increases in local competition are associated with increases in clinical quality and patient satisfaction, particularly for firms with lower quality. However, the magnitude of the effect is small.
Keywords: quality; healthcare; choice; competition; family physicians
JEL Codes: I11; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Increases in local competition (L13) | Increases in clinical quality (I11) |
| Increases in local competition (L13) | Increases in patient satisfaction (I11) |
| Increases in local competition (L13) | Improvements in quality metrics (L15) |
| One additional GP in a rival practice (J19) | Increases in clinical performance (D29) |