Patient hospital choice for hip replacement: empirical evidence from the Netherlands

In the Dutch health care system, hospitals are expected to compete. A necessary condition for competition among hospitals is that patients do not automatically choose the nearest hospital, but are—at least to some extent—sensitive to differences in hospital quality. In this study, an analysis is per...

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Bibliographic Details
Published in:The European journal of health economics 2014-12, Vol.15 (9), p.927-936
Main Authors: Beukers, Puck D. C., Kemp, Ron G. M., Varkevisser, Marco
Format: Article
Language:English
Subjects:
Aged
Arthroplasty, Replacement, Hip
Choice Behavior
competition
Databases, Factual
Economic Policy
Empirical Research
Female
Health Care Management
Health care waiting times
Health Economics
Health insurance
Hip prostheses
Hospitals
Hospitals - standards
Humans
Insurance providers
Male
Market share
Medicine
Medicine & Public Health
Modeling
Netherlands
Original Paper
Patient Preference
Pharmacoeconomics and Health Outcomes
Public Finance
Public Health
quality
Reoperation
report cards
Teaching hospitals
Travel time
Waiting Lists
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Summary:In the Dutch health care system, hospitals are expected to compete. A necessary condition for competition among hospitals is that patients do not automatically choose the nearest hospital, but are—at least to some extent—sensitive to differences in hospital quality. In this study, an analysis is performed on the underlying features of patient hospital choice in a setting where prices do not matter for patients as a result of health insurance coverage. Using claims data from all Dutch hospitals over the years 2008-2010, a conditional logit model examines the relationship between patient characteristics (age, gender and reoperations) and hospital attributes (hospital quality information, waiting times on treatments and travel time for patients to the hospitals) in the market for general nonemergency hip replacement treatments. The results show that travel time is the most important determinant in patient hospital choice. From our analysis, however, it follows that publicly available hospital quality ratings and waiting times also have a significant impact on patient hospital choice. The panel data used for this study (2008-2010) is rather short, which may explain why no coherent and persistent changes in patient hospital choice behaviour over time are found.
ISSN:1618-7598
1618-7601
DOI:10.1007/s10198-013-0535-7