Research Interests: Business, Economics, Public Economics, Health Economics, Health Care, and 15 moreSocial Justice, Medicine, Applied Economics, Human Resources for Health, Health Services, Data Collection, Income, National Health Service, Great Britain, Morbidity, Public health systems and services research, Statistical models, Equity Law, Socioeconomic Factors, and Health Resources
Research Interests: Business, Economics, Political Economy, Productivity, Public Health, and 15 morePublic sector, Labour Economics, Panel Data, Developing Country, Labour Market, Quality of Service, Labor Market, Acute Myocardial Infarction, Nursing Home, Harm, Hospital Productivity, Hospital Quality, Labour Supply, Labor Supply, and Service Sector
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This paper examines the effect of peers and networks on the uptake of innovation in surgery.Using a rich matched patient-surgeon data set covering all relevant surgeons, we construct a wide set of time varying measures of peer behaviour... more
This paper examines the effect of peers and networks on the uptake of innovation in surgery.Using a rich matched patient-surgeon data set covering all relevant surgeons, we construct a wide set of time varying measures of peer behaviour and network effects. Our estimates allow for simultaneity bias and treatment of the network as partially unknown. The findings show the importance of multiple channels in affecting the diffusion of innovative behaviour across individual surgeons.
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Choice in public services is controversial. We exploit a reform in the English National Health Service to assess the effect of removing constraints on patient choice. We estimate a demand model that explicitly captures the removal of the... more
Choice in public services is controversial. We exploit a reform in the English National Health Service to assess the effect of removing constraints on patient choice. We estimate a demand model that explicitly captures the removal of the choice constraints imposed on patients. We find that, post-removal, patients became more responsive to clinical quality. This led to a modest reduction in mortality and a substantial increase in patient welfare. The elasticity of demand faced by hospitals increased substantially post-reform and we find evidence that hospitals responded to the enhanced incentives by improving quality. This suggests greater choice can raise quality. (JEL D12, I11, I18)
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Research Interests: Economics and Health Care
We study the effect of internet diffusion on childbirth procedures performed in England between 2000 and 2011. We exploit an identification strategy based on geographical discontinuities in internet diffusion generated by technological... more
We study the effect of internet diffusion on childbirth procedures performed in England between 2000 and 2011. We exploit an identification strategy based on geographical discontinuities in internet diffusion generated by technological factors. Our design shuts off the role of financial incentives for suppliers. We show that broadband internet access increased Cesarean-sections: mothers living in areas with better internet access are 1.8 percent more likely to have a C-section than mothers living in areas with worse internet access. The effect is driven by firsttime mothers who are 2.5 percent more likely to obtain an elective C-section. The increased C-section rate is not accompanied by changes in health care outcomes of mothers and newborns. Therefore, health care costs increased with no corresponding medical benefits for patients. Heterogeneity analysis shows that mothers with low income and low education are those more affected: thanks to the internet, they progressively close t...
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Research Interests: Business, Economics, Social Sciences, Behavior, Health Care, and 15 moreBusiness Economics, Regulation, Labour Economics, Applied Economics, Quality of Care, Production economics, Physicians, Nurses, Incentive, Business Finance, Management Practices, Labour Supply, Pay for performance, Regional Variations, and Patient Preferences
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The use of private welfare services in the UK has risen. But relatively little is known about the patterns of use of private welfare services. This article investigates whether there is a private welfare class, and how attitudes to... more
The use of private welfare services in the UK has risen. But relatively little is known about the patterns of use of private welfare services. This article investigates whether there is a private welfare class, and how attitudes to welfare state spending are linked to use of private services. It finds that there is considerable use of the private sector, but the size of the group consistently using a range of private welfare services is small. Changes in attitudes to public financing of welfare spending do not appear to be directly linked to use of private services.
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Research Interests: Economics, Health Economics, Health Care, Health insurance, Health, and 15 moreHealth Services Research, Health Policy, Applied Economics, Finland, Germany, Humans, Europe, Health Care Financing, International comparisons, International Comparison, Income, Cross Section, Comparability, Equity Law, and Delivery of Health Care
Research Interests: Geography, Health Economics, Health inequality, Health Policy, Medicine, and 15 moreApplied Economics, Humans, Latent variable, East Germany, Inequality, Regression Analysis, International comparisons, International Comparison, Income, Health Status, Health Care Rationing, Developed Countries, Public health systems and services research, Countries, and inequalities in health
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Recent studies have demonstrated the importance of good management for firm performance. Here, we focus on management in not-for-profits (NFPs). We present a model predicting that management quality will be lower in NFPs compared to... more
Recent studies have demonstrated the importance of good management for firm performance. Here, we focus on management in not-for-profits (NFPs). We present a model predicting that management quality will be lower in NFPs compared to for-profits (FPs), but that outputs may not be worse if managers are altruistic. Using a tried and tested survey of management practices, we find that NFPs score lower than FPs but also that, while the relationship between management scores and outputs holds for FPs, the same is not true for NFPs. One implication is that management practices that work for FPs may be less effective in driving performance in NFPs.
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This article examines whether an extension of private finance would improve either the efficiency or the equity of the UK health care system. A number of arguments for increasing the role of private finance that focus on the impact of... more
This article examines whether an extension of private finance would improve either the efficiency or the equity of the UK health care system. A number of arguments for increasing the role of private finance that focus on the impact of private finance on the efficiency of the public sector are examined in conjunction with empirical evidence from a number of OECD countries. The conclusion is that the case for some extension of private finance is finely balanced. There is little evidence to show that increasing private finance would improve the efficiency of the NHS. On the other hand, the evidence suggests that it is unlikely that increasing private finance at the margin will alter the support for the NHS, and thus willingness of individuals to pay taxes for public care. In addition, if private finance is supplementary, increased finance will be progressive in terms of payments for health care.
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Research Interests: Economics and Equity Law
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We investigate an underexplored externality of crime: the impact of violent crime on individuals' participation in walking. For many adults walking is the only regular physical activity. We use a sample of nearly 1 million people in... more
We investigate an underexplored externality of crime: the impact of violent crime on individuals' participation in walking. For many adults walking is the only regular physical activity. We use a sample of nearly 1 million people in 323 small areas in England between 2005 and 2011 matched to quarterly crime data at the small area level. Within area variation identifies the causal effect of local violent crime on walking and a difference-in-difference analysis of two high-profile crimes corroborates our results. We find a significant deterrent effect of violent crime on walking that translates into a drop in overall physical activity.