DP12917 Spatial competition and quality: Evidence from the English family doctor market

Author(s): Hugh S Gravelle, Dan Liu, Carol Propper, Rita Santos
Publication Date: May 2018
Keyword(s): Choice, Competition, family physicians, healthcare, Quality
JEL(s): I11, I18
Programme Areas: Public Economics
Link to this Page: cepr.org/active/publications/discussion_papers/dp.php?dpno=12917

We examine whether family doctor firms in England respond to local competition by increasing their quality. We measure quality in terms of clinical performance and patient-reported satisfaction to capture its multi-dimensional nature. We use a panel covering 8 years for over 8000 English general practices, allowing us to control for unobserved local area effects. We measure competition by the number of rival doctors within a small distance. We find that increases in local competition are associated with increases in clinical quality and patient satisfaction, particularly for firms with lower quality. However, the magnitude of the effect is small.