Featured Research

from universities, journals, and other organizations

UK experts question merits of extending competition to improve hospital care

Date:
October 10, 2011
Source:
BMJ-British Medical Journal
Summary:
More research is needed before conclusions can be drawn about the effect of recent reforms on hospital quality, let alone about the merits of the coalition government's proposals to extend competition, warn UK experts.

More research is needed before conclusions can be drawn about the effect of recent reforms on hospital quality, let alone about the merits of the coalition government's proposals to extend competition, warn experts in the British Medical Journal online.

Professor Gwyn Bevan and Matthew Skellern at the London School of Economics and Political Science argue that the jury is still out on the effects of hospital competition on quality of care within the English NHS.

Their views come as the Health and Social Care Bill has its second reading in the House of Lords on Oct. 11.

The health secretary, Andrew Lansley, has proposed changes to the English NHS that will extend the hospital market introduced by "New Labour" in the 2000s. This was the second era of hospital competition within the NHS; the first, the "internal market," applied throughout the UK from 1991 to 1997.

Bevan and Skellern review evidence from three recent econometric studies of the New Labour market, which all show a seemingly causal relation between greater competition and lower hospital mortality. These studies have proved highly controversial because they contradict previous findings that competition in the NHS was largely ineffective, or even had negative consequences.

The authors argue that the three recent econometric studies are "serious and rigorous responses to the challenge of estimating the effects of competition on hospital outcomes." However, they question their use of hospital mortality rates (HMRs) to judge the impact of competition on the quality of elective surgery because deaths following elective surgery are so rare that another measure is needed to assess its quality.

Two econometric studies examining the effects of introducing patient choice in elective surgery assume that this competition will improve elective surgery, which will require improving hospital management in ways that lead to across the board improvements in hospital quality. The authors argue that: "It is equally plausible, however, that such competition for elective surgery might, through diversion of management effort, negatively affect the quality of other hospital services." Hence the authors believe that "a key finding of these two studies is that introducing patient choice for elective surgery in the New Labour market did not reduce quality elsewhere in hospitals."

"We believe there are strong grounds for introducing patient choice into the NHS as an end in itself, given its potential to empower patients and give them greater control over the conditions of their care," say the authors. Nevertheless, they add, how patient choice has affected outcomes in elective surgery "remains an open question."

They conclude: "More research is required before conclusions can be drawn about the effect of recent reforms on hospital quality, let alone about the merits of the Mr Lansley's proposals further to extend competition."


Story Source:

The above story is based on materials provided by BMJ-British Medical Journal. Note: Materials may be edited for content and length.


Journal Reference:

  1. G. Bevan, M. Skellern. Does competition between hospitals improve clinical quality? A review of evidence from two eras of competition in the English NHS. BMJ, 2011; 343 (oct07 2): d6470 DOI: 10.1136/bmj.d6470

Cite This Page:

BMJ-British Medical Journal. "UK experts question merits of extending competition to improve hospital care." ScienceDaily. ScienceDaily, 10 October 2011. <www.sciencedaily.com/releases/2011/10/111010212010.htm>.
BMJ-British Medical Journal. (2011, October 10). UK experts question merits of extending competition to improve hospital care. ScienceDaily. Retrieved April 17, 2014 from www.sciencedaily.com/releases/2011/10/111010212010.htm
BMJ-British Medical Journal. "UK experts question merits of extending competition to improve hospital care." ScienceDaily. www.sciencedaily.com/releases/2011/10/111010212010.htm (accessed April 17, 2014).

Share This



More Health & Medicine News

Thursday, April 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Obama: 8 Million Healthcare Signups

Obama: 8 Million Healthcare Signups

AP (Apr. 17, 2014) President Barack Obama gave a briefing Thursday announcing 8 million people have signed up under the Affordable Care Act. He blasted continued Republican efforts to repeal the law. (April 17) Video provided by AP
Powered by NewsLook.com
Is Apathy A Sign Of A Shrinking Brain?

Is Apathy A Sign Of A Shrinking Brain?

Newsy (Apr. 17, 2014) A recent study links apathetic feelings to a smaller brain. Researchers say the results indicate a need for apathy screening for at-risk seniors. Video provided by Newsy
Powered by NewsLook.com
Could Even Casual Marijuana Use Alter Your Brain?

Could Even Casual Marijuana Use Alter Your Brain?

Newsy (Apr. 16, 2014) A new study conducted by researchers at Northwestern and Harvard suggests even casual marijuana use can alter your brain. Video provided by Newsy
Powered by NewsLook.com
Thousands Of Vials Of SARS Virus Go Missing

Thousands Of Vials Of SARS Virus Go Missing

Newsy (Apr. 16, 2014) A research institute in Paris somehow misplaced more than 2,000 vials of the deadly SARS virus. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins