Hugh Gravelle - The Effect of Hospital Ownership on Quality of Care

Title: The Effect of Hospital Ownership on Quality of Care

Abstract: Hospital care in the English NHS is free at point of use and NHS patients can choose to be treated at any qualified provider, whether public or private. Around 11% of planned admissions of NHS patients are to private hospitals. Theoretical models yield ambiguous predictions about the effect of ownership on quality. Previous comparisons of quality of care between public and private hospitals have been for a small number of treatments and have produce mixed results. In this paper we investigate the quality of planned care for 3.8 million NHS patients for 133 treatments in 393 public and 190 private hospital sites. OLS estimates suggest that private hospitals have lower emergency readmission rates but may be biased if unobservedly more morbid patients choose hospitals on the basis of their perceived quality. Using differences in distances to public and private providers as instruments variables we find that there is no statistically significant effect of ownership. There are also no quality differences between specialist and non-specialist hospitals or between for profit and not for profit hospitals. We do find that results vary by treatment type with private providers having higher emergency readmission rates for non-diagnositic treatments.

Presenter: Hugh Gravelle, University of York

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