Imperial College London

Professor Mauro Laudicella

Business School

Honorary Research Fellow
 
 
 
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Contact

 

+44 (0)20 7594 9765m.laudicella

 
 
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Location

 

Sherfield BuildingSouth Kensington Campus

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Summary

 

Publications

Publication Type
Year
to

15 results found

Laverty AA, Laudicell M, Smith PC, Millett Cet al., 2015, Impact of ‘high-profile’ public reporting on utilization and quality of maternity care in England: a difference-in-difference analysis, Journal of Health Services Research & Policy, ISSN: 1355-8196

Journal article

Carrera PM, Laudicella M, 2014, Competitive healthcare and the elderly: handle with care., Maturitas, Vol: 78, Pages: 151-152

Journal article

Smith PC, Laudicella M, Li Donni P, 2013, Hospital quality and costs: evidence from England, Publisher: Imperial College Business School

Working paper

Cookson R, Laudicella M, Li Donni P, 2013, Does hospital competition harm equity? Evidence from the English National Health Service, Journal of Health Economics, Vol: 32, Pages: 410-422

Increasing evidence shows that hospital competition under fixed prices can improve quality and reduce cost. Concerns remain, however, that competition may undermine socio-economic equity in the utilisation of care. We test this hypothesis in the context of the pro-competition reforms of the English National Health Service progressively introduced from 2004 to 2006. We use a panel of 32,482 English small areas followed from 2003 to 2008 and a difference in differences approach. The effect of competition on equity is identified by the interaction between market structure, small area income deprivation and year. We find a negative association between market competition and elective admissions in deprived areas. The effect of pro-competition reform was to reduce this negative association slightly, suggesting that competition did not undermine equity.

Journal article

Cookson R, Laudicella M, Li Donni P, 2012, Measuring change in health care equity using smallarea administrative data - evidence from the English NHS 2001-8, Social Science & Medicine, Vol: 75, Pages: 1514-1522

This study developed a method for measuring change in socio-economic equity in health care utilisation using small area level administrative data. Our method provides more detailed information on utilisation than survey data but only examines socio-economic differences between neighbourhoods rather than individuals. The context was the English NHS from 2001 to 2008, a period of accelerated expenditure growth and pro-competition reform. Hospital records for all adults receiving nonemergency hospital care in the English NHS from 2001 to 2008 were aggregated to 32,482 English small areas with mean population about 1,500 and combined with other small area administrative data. Regression models of utilisation were used to examine year-on-year change in the small area association between deprivation and utilisation, allowing for population size, age-sex composition and disease prevalence including (from 2003-8) cancer, chronic kidney disease, coronary heart disease, diabetes, epilepsy, hypertension, hypothyroidism, stroke, transient ischaemic attack and (from 2006-8) atrial fibrillation, chronic obstructive pulmonary disease, obesity and heart failure. There was no substantial change in small area associations between deprivation and utilisation for outpatient visits, hip replacement, senile cataract, gastroscopy or coronary revascularisation, though overall nonemergency inpatient admissions rose slightly faster in more deprived areas than elsewhere. Associations between deprivation and disease prevalence changed little during the period, indicating that observed need did not grow faster in more deprived areas than elsewhere. We conclude that there was no substantial deterioration in socio-economic equity in health care utilisation in the English NHS from 2001 to 2008, and if anything, there may have been a slight improvement.

Journal article

Gaynor M, Laudicella M, Propper C, 2012, Can governments do it better? Merger mania and hospital outcomes in the English NHS, Journal of Health Economics, Vol: 31, Pages: 528-543

The literature on mergers between private hospitals suggests that such mergers often produce little benefit. Despite this, the UK government has pursued an active policy of hospital mergers, arguing that such consolidations will bring improvements for patients. We examine whether this promise is met. We exploit the fact that between 1997 and 2006 in England around half the short term general hospitals were involved in a merger, but that politics means that selection for a merger may be random with respect to future performance. We examine the impact of mergers on a large set of outcomes including financial performance, productivity, waiting times and clinical quality and find little evidence that mergers achieved gains other than a reduction in activity. Given that mergers reduce the scope for competition between hospitals the findings suggest that further merger activity may not be the appropriate way of dealing with poorly performing hospitals.

Journal article

Cookson R, Laudicella M, Li Donni P, Dusheiko Met al., 2012, Effects of the Blair/Brown health reforms onsocioeconomic equity in health care, Journal of Health Services Research and Policy; Forthcoming

Journal article

Laudicella M, Siciliani L, Cookson R, 2012, Waiting times and socioeconomic status: evidence from England, Social Science and Medicine; Forthcoming

Journal article

Bojke C, Castelli A, Laudicella M, Street A, Ward Pet al., 2012, Regional variation in the productivity of the English National Health Service, Health Economics; Forthcoming

Journal article

Laudicella M, Smith PC, 2011, A review of Health Economic Expertise in Cancer

Report

Castelli A, Laudicella M, Street A, Ward Pet al., 2011, Getting out what we put in: productivity of the English National Health Service, HEALTH ECONOMICS POLICY AND LAW, Vol: 6, Pages: 313-335, ISSN: 1744-1331

Journal article

Cookson R, Laudicella M, 2010, Do the poor cost much more? The relationship between small area income deprivation and length of stay for elective hip replacement in the English NHS from 2001 to 2008., Soc Sci Med (Forthcoming)

The Blair/Brown reforms of the English NHS in the early to mid 2000s gave hospitals strong new incentives to reduce waiting times and length of stay for elective surgery. One concern was that these efficiency-oriented reforms might harm equity, by giving hospitals new incentives to select against socio-economically disadvantaged patients who stay longer and cost more to treat. This paper aims to assess the magnitude of these new selection incentives in the test case of hip replacement. Anonymous hospital records are extracted on 274,679 patients admitted to English NHS Hospital Trusts for elective total hip replacement from 2001/2 through 2007/8. The relationship between length of stay and small area income deprivation is modelled allowing for other patient characteristics (age, sex, number and type of diagnoses, procedure type) and hospital effects. After adjusting for these factors, we find that patients from the most deprived tenth of areas stayed just 6% longer than others in 2001/2, falling to 2% by 2007/8. By comparison, patients aged 85 or over stayed 57% longer than others in 2001/2, rising to 71% by 2007/8, and patients with seven or more diagnoses stayed 58% longer than others in 2001/2, rising to 73% by 2007/8. We conclude that the Blair/Brown reforms did not give NHS hospitals strong new incentives to select against socio-economically deprived hip replacement patients.

Journal article

Laudicella M, Olsen KR, Street A, 2010, Examining cost variation across hospital departments-a two-stage multi-level approach using patient-level data, SOCIAL SCIENCE & MEDICINE, Vol: 71, Pages: 1872-1881, ISSN: 0277-9536

Journal article

Kristensen T, Laudicella M, Ejersted C, Street Aet al., 2010, Cost variation in diabetes care delivered in English hospitals, DIABETIC MEDICINE, Vol: 27, Pages: 949-957, ISSN: 0742-3071

Journal article

Laudicella M, Cookson R, Jones AM, Rice Net al., 2009, Health care deprivation profiles in the measurement of inequality and inequity: An application to GP fundholding in the English NHS, JOURNAL OF HEALTH ECONOMICS, Vol: 28, Pages: 1048-1061, ISSN: 0167-6296

Journal article

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