Unpacking the evidence on competition and outcomes in the NHS in England

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    5 Citations (Scopus)


    In 2006 the NHS in England adopted a system in which patients were given choices between secondary care providers which were paid fixed prices (so called ‘payment by results’) for providing care. Gaynor et al have suggested that before 2006, hospitals did not compete and that competition after that date led to changes in travel patterns for patients in and around conurbations toward hospitals with both shorter waiting lists and higher clinical quality (according to one measure).1 Furthermore, those hospitals facing more competition (as they measured it) had better clinical quality after this reorganization, leading to the claim that competition saves lives2 and lowers lengths of stay, without any increase in total health expenditure.
    Original languageEnglish
    Pages (from-to)193-194
    Number of pages2
    JournalJournal of Health Services Research & Policy
    Issue number4
    Publication statusPublished - 31 Oct 2012


    • economic competition
    • health care reform
    • humans
    • outcome assessment (health care)
    • state medicine


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