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

• 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
• ISSN: 1618-7598; 1618-7601
• DOI: 10.1007/s10198-013-0535-7

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.