How increased ‘competition’ can improve hospitals

New research from a peer-reviewed academic journal:

We analyse the causal impact of competition on managerial quality and hospital performance… We find that higher competition results in higher management quality, measured using a new survey tool, and improved hospital performance. Adding a rival hospital increases management quality by 0.4 standard deviations and increases survival rates from emergency heart attacks by 9.7%.

I put competition in quotes in the headline because it is the word used in the research, but it’s also a word that often summons up images of financial competition when what’s more the case here it seems is the (potential) exercise of choice by citizens.

There are good liberal reasons for giving people choice anyway (‘no, you can’t choose for yourself’ doesn’t exactly roll off a liberal tongue), but this is one more piece of evidence in the nuanced and growing collection of knowledge about when it does and doesn’t improve the quality of a service in other ways too.

On which see my post from 2012, and especially Alex Marsh’s comment there and also my review of David Boyle’s excellent work on giving citizens more choice.