Santos Rita, Gravelle Hugh, Propper Carol
University of York.
University of Bristol Imperial College London and CEPR.
Econ J (London). 2017 Mar;127(600):445-494. doi: 10.1111/ecoj.12282. Epub 2016 Feb 23.
Reforms giving users of public services choice of provider aim to improve quality. But such reforms will work only if quality affects choice of provider. We test this crucial prerequisite in the English health care market by examining the choice of 3.4 million individuals of family doctor. Family doctor practices provide primary care and control access to non-emergency hospital care, the quality of their clinical care is measured and published and care is free. In this setting, clinical quality should affect choice. We find that a 1 standard deviation increase in clinical quality would increase practice size by around 17%.
赋予公共服务用户选择服务提供者权利的改革旨在提高服务质量。但只有当质量影响服务提供者的选择时，此类改革才会起作用。我们通过研究340万个人对家庭医生的选择，来检验英国医疗保健市场中的这一关键前提条件。家庭医生诊所提供初级医疗服务并控制非急诊医院护理的就诊机会，其临床护理质量会被衡量并公布，且医疗服务是免费的。在这种情况下，临床质量应该会影响选择。我们发现，临床质量提高1个标准差会使诊所规模增加约17%。
