Spatial competition and quality: Evidence from the English family doctor market

Hugh Gravelle*, Dan Liu, Carol Propper, Rita Santos

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

17 Citations (Scopus)


We examine whether family doctor firms in England respond to local competition by increasing their quality. We measure quality in terms of clinical performance and patient-reported satisfaction to capture its multi-dimensional nature. We use a panel covering 8 years for over 8000 English general practices. We measure competition as the number of rival doctors within a small distance and control for a large number of potential confounders. We find that increases in local competition are associated with increases in patient satisfaction and to a lesser extent in clinical quality. However, the magnitude of the effect is small.

Original languageEnglish
Article number102249
Number of pages15
JournalJournal of Health Economics
Early online date17 Oct 2019
Publication statusPublished - 1 Dec 2019


  • Choice
  • Competition
  • Family
  • Healthcare
  • Physicians
  • Quality


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