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Do small hospitals have lower quality? Evidence from the English NHS

Bibliographic Data

ID4600536
AuthorsJames Gaughan (0000-0002-8409-140X, University of York), Luigi Siciliani (0000-0003-1739-7289, University of York, corresponding author), H Gravelle (0000-0002-7753-4233, University of York), Giuseppe Moscelli (0000-0002-0675-1564, University of Surrey)
Year2020
Volume265
Pages113500
Publication date2020-11-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2020.113500
PMID33221070
OpenAlexW3094776491
LanguageEN
Citations received2
References cited21

We investigate the extent to which small hospitals are associated with lower quality. We first take a patient perspective, and test if, controlling for casemix, patients admitted to small hospitals receive lower quality than those admitted to larger hospitals. We then investigate if differences in quality between large and small hospitals can be explained by hospital characteristics such as hospital type and staffing. We use a range of quality measures including hospital mortality rates (overall and for specific conditions), hospital acquired infection rates, waiting times for emergency patients, and patient perceptions of the care they receive. We find that small hospitals, with fewer than 400 beds, are generally not associated with lower quality before or after controlling for hospital characteristics. The only exception is heart attack mortality, which is generally higher in small hospitals

Family medicine · Health care · Hospital care · Medical emergency · Quality (philosophy · Staffing · Global Health Care Issues · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Emergency Medicine

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Unique citing works2
Citations per year1
Citation span2024 - 2025 (2)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 2

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