Navigation Links
Experts question merits of extending competition to improve hospital care
Date:10/10/2011

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 on bmj.com today.

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 Tuesday 11 October.

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."


'/>"/>

Contact: Emma Dickinson
edickinson@bmjgroup.com
44-020-738-36529
BMJ-British Medical Journal
Source:Eurekalert

Related medicine news :

1. Panels Rejection of PSA Test Spurs Mixed Reaction From Experts
2. Experts Assess What Works for Weight Loss
3. Experts Point Out Signs of Dangerous Heart Rhythm
4. Check Plastic Surgeons Credentials or Risk Tragic Results, Experts Warn
5. Experts Revise Guidelines for Whooping Cough Vaccination
6. Bone experts to present strategies for osteoporosis prevention and care in Dubai
7. Experts offer solutions at ACR Imaging Informatics Summit & Radiation Dose Monitoring Forum
8. Less Play Time = More Troubled Kids, Experts Say
9. Movement Disorders on YouTube Not What They Seem, Experts Warn
10. Health Experts Say HPV Vaccine Is Safe
11. Trauma experts criticize BBCs Holby City for peddling dangerous drugs
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/4/2016)... ... , ... Recognizing that lifestyle medicine is essential to health and healthcare, ... Katz, MD, MPH, president of the American College of Lifestyle Medicine, as their first ... gratifying,” said Katz. “There is so much opportunity to add years to lives, and ...
(Date:5/4/2016)... ... ... The preeminent surgical aftercare facility Pearl Recovery Retreat was pleased to provide ... 2016, the 61-year-old model and reality TV star was diagnosed with early stage ductal ... according to an interview with the Daily Mail Online . , Following ...
(Date:5/4/2016)... , ... May 04, 2016 ... ... compression and support for knees, ankles, and elbows. Engineered with athletes in ... 3D flat-bed manufacturing (opposed to ineffective circular knitting, common in the industry) ...
(Date:5/4/2016)... Angeles, California (PRWEB) , ... May 04, 2016 , ... ... Cancer Research (AACR) honors the month of May as National Cancer Research Month. According ... 1.6 million new diagnoses of cancer with predications of one in four Americans dying ...
(Date:5/4/2016)... ... 04, 2016 , ... International Conference on Obesity and Chronic ... at Las Vegas. It aims to bring together academicians, scientists, dietitians, surgeons, physicians, ... across the globe; making the conference a perfect platform to share experience and ...
Breaking Medicine News(10 mins):
(Date:5/3/2016)... 3, 2016 Norgine ... sie einen entscheidenden Meilenstein durch diese Veröffentlichung ... zum Handeln, um Patientenresultate  bei Verdauungs- und ... Fortschritten im Verständnis der Hepatischen Enzephalopathie bei ... für Hepatische Enzephalopathie in der Öffentlichkeit zu ...
(Date:5/2/2016)...  While nearly three-quarters of Americans (71%) are aware ... health, only about half report taking any steps to ... a new survey announced today by Hologic (Nasdaq: ... Osteoporosis Month, Hologic is raising awareness of this major ... Americans. Osteoporosis is a disease that causes ...
(Date:4/29/2016)... April 29, 2016 ReportsnReports.com ... 2016" market research report that provides an overview ... analysis at various stages, therapeutics assessment by drug ... (RoA) and molecule type, along with latest updates, ... reviews key players involved in the therapeutic development ...
Breaking Medicine Technology: