Please use this identifier to cite or link to this item: http://hdl.handle.net/10419/161099
Authors: 
Gobillon, Laurent
Milcent, Carine
Year of Publication: 
2017
Series/Report no.: 
IZA Discussion Papers 10476
Abstract: 
We evaluate the effect of a pro-competition reform gradually introduced in France over the 2004-2008 period on hospital quality measured with the mortality of heart-attack patients. Our analysis distinguishes between hospitals depending on their status: public (university or non-teaching), non-profit or for-profit. These hospitals differ in their degree of managerial and financial autonomy as well as their reimbursement systems and incentives for competition before the reform, but they are all under a DRG-based payment system after the reform. For each hospital status, we assess the benefits of local competition in terms of decrease in mortality after the reform. We estimate a duration model for mortality stratified at the hospital level to take into account hospital unobserved heterogeneity and censorship in the duration of stays in a flexible way. Estimations are conducted using an exhaustive dataset at the patient level over the 1999-2011 period. We find that non-profit hospitals, which have managerial autonomy and no incentive for competition before the reform, enjoyed larger declines in mortality in places where there is greater competition than in less competitive markets.
Subjects: 
competition
hospital ownership
policy evaluation
heart attack
JEL: 
I11
I18
Document Type: 
Working Paper

Files in This Item:
File
Size
601.34 kB





Items in EconStor are protected by copyright, with all rights reserved, unless otherwise indicated.