Andrew Street: Market mechanisms in health care

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Andrew Street: Market mechanisms in health care

  1. 1. Andrew Street Professor of Health Economics Competition and market mechanisms in health care: overview
  2. 2.  Competition ≠ privatisation  Competition is not directly observable  Competitive effects are conditional on other features  Competition is not the only instrument
  3. 3.  Competition ≠ privatisation  But people are (rightly) suspicious  Telecoms, British Rail, Royal Mail  Private sector treatment centres  Lower LoS  But paid (much) more than they have delivered
  4. 4.  Competition is not directly observable  Distance measures – how many organisations are in the vicinity or how far away is the nearest organisation?  Are neighbouring organisations …  Competing?  Collaborating?  Differentiating?  Additional measures – patient choice, qualitative information
  5. 5. Care homes Hospitals >10,000 150 Flexible pricing National tariff Neutral? Reduced? Number Price Quality  Competitive effects are conditional
  6. 6.  Competition is not the only instrument  Yardstick competition – Payment by Results  Collaboration – integrated care  Closures

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