ArticleHealth economics review2022
Competition and quality of care under regulated fees: evidence from Ghana.
Article in Health economics review, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- The impact of hospital competition on healthcare quality: evidence from China's healthcare reform.Frontiers in public health · 2025Article
- Article
- Examining patient choice and provider competition under the National Health Insurance Fund outpatient cover in Kenya: does it enhance access and quality of care?BMC health services research · 2024Article
- Leveraging local health system resources to address quality healthcare gaps in sub-Saharan African: lessons from the SafeCare quality improvement programme in Ghana.BMC health services research · 2024Article
- The Impact of Hospital Competition on the Quality of Care in Europe: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- Impact of health system governance on healthcare quality in low-income and middle-income countries: a scoping review.BMJ open · 2023Article
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Authors and funding
2 authors.
Funding
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Abstract
backgroundHow competition affects the quality of care is still not well understood empirically because of limited and mixed results. This study examined whether competition leads to higher or lower quality health outcomes in Ghana.
methodsWe used administrative claims data of hypertension patients for 2017 - 2019 (36 months), and an instrumental variable method to examine the effect of competition, measured as an increase in district doctor-to-population ratio on hospital-level ambulatory care sensitive condition hospitalization and in-hospital death rates.
resultsOverall, we found that an increase in doctor density improves the quality of care for hypertension patients in Ghana. That is, when there are more doctors, fewer patients are hospitalized, and the risk of in-hospital deaths decreases. This result is robust to analyses at the individual and district population levels for ambulatory care sensitive hospitalizations rate.
conclusionsOur findings suggest that in the presence of physician-induced demand, competition can lead to improvement in the quality of care, possibly through improved access to healthcare and increased physician time and contact per patient. Future health policies need to consider possible welfare benefits of induced medical services and training more doctors.
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