Patient Choice, Mobility and Competition Among Health Care Providers

  • Kurt R. Brekke
  • Hugh Gravelle
  • Luigi SicilianiEmail author
  • Odd Rune Straume
Part of the Developments in Health Economics and Public Policy book series (HEPP, volume 12)


Policymakers are increasingly designing policies that encourage patient choice and therefore mobility across providers. Since prices are regulated (fixed) in most countries, providers need to compete on quality to attract patients. This chapter reviews the current theoretical and empirical literature on patient choice and quality competition in health markets. The theoretical literature identifies key factors affecting incentives to provide quality. These include: altruistic motives, cost structure, number of providers, demand responsiveness, GP gatekeeping, degree of specialization, profit constraints and soft budgets. We also review the theoretical literature on choice across different countries (e.g. within the EU) or regions within the same countries. The chapter reviews selected empirical studies that investigate whether demand responds to quality and waiting times, the role of patient’s mobility and the effect of competition on quality.


Choice Quality competition 

JEL Classification

H42 I18 I21 L13 


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Copyright information

© Springer-Verlag Italia 2014

Authors and Affiliations

  • Kurt R. Brekke
    • 1
  • Hugh Gravelle
    • 2
  • Luigi Siciliani
    • 3
    Email author
  • Odd Rune Straume
    • 4
    • 5
  1. 1.Department of EconomicsNorwegian School of EconomicsBergenNorway
  2. 2.Centre for Health EconomicsUniversity of YorkHeslingtonUK
  3. 3.Department of Economics and Related Studies, and Centre for Health EconomicsUniversity of YorkHeslingtonUK
  4. 4.Department of Economics/NIPEUniversity of MinhoBragaPortugal
  5. 5.Department of EconomicsUniversity of BergenBergenNorway

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