Economic studies showing positive competition effects on hospital performance fully controlled for the factors cited by recent critics

Criticisms have been made of recent influential studies that show improving performance in hospitals operating in more competitive environments compared with hospitals that have a local monopoly on care. Zack Cooper, Steve Gibbons, Simon Jones and Alistair McGuire set the record straight. The claims by Pollock et al are based either on distortions of the original research, or on an apparent lack of understanding of modern economic analysi

Does hospital competition save lives? Evidence from the English NHS patient choice reforms

This paper examines whether or not hospital competition in a market with fixed reimbursement prices can prompt improvements in clinical quality. In January 2006, the British Government introduced a major extension of their market-based reforms to the English National Health Service. From January 2006 onwards, every patient in England could choose their hospital for secondary care and hospitals had to compete with each other to attract patients to secure their revenue. One of the central aims of this policy was to create financial incentives for providers to improve their clinical performance. This paper assesses whether this aim has been achieved and competition led to improvements in quality. For our estimation, we exploit the fact that choice-based reforms will create sharper financial incentives for hospitals in markets where choice is geographically feasible and that prior to 2006, in the absence of patient choice, hospitals had no direct financial incentive to improve performance in order to attract more patients. We use a modified difference-in-difference estimator to analyze whether quality improved more quickly in more competitive markets after the government introduced its new wave of market-based reforms. Using AMI mortality as a quality indicator, we find that mortality fell more quickly (i.e. quality improved) for patients living in more competitive markets after the introduction of hospital competition in January 2006. Our results suggest that hospital competition in markets with fixed prices can lead to improvements in clinical quality

Surface code implementation of block code state distillation

State distillation is the process of taking a number of imperfect copies of a particular quantum state and producing fewer better copies. Until recently, the lowest overhead method of distilling states |A>=(|0>+e^{i\pi/4}|1>)/\sqrt{2} produced a single improved |A> state given 15 input copies. New block code state distillation methods can produce k improved |A> states given 3k+8 input copies, potentially significantly reducing the overhead associated with state distillation. We construct an explicit surface code implementation of block code state distillation and quantitatively compare the overhead of this approach to the old. We find that, using the best available techniques, for parameters of practical interest, block code state distillation does not always lead to lower overhead, and, when it does, the overhead reduction is typically less than a factor of three.Comment: 26 pages, 28 figure

Is there a net generation coming to university?

This paper reports the first phase of an ESRC funded research project to investigate first year students' use of technology in relation to the idea of young people born after 1983 forming a distinct age cohort described variously as the Net generation or Digital Natives. The research took place in five English universities in the spring of 2008. The research found a far more complex picture than that suggested by the rhetoric with student use of new technologies varying between different universities and courses. Some of the more discussed new technologies such as blogs, wikis and virtual worlds were shown to be less used by students than might have been expected. The Net generation appears if anything to be a collection of minorities with a small number of technophobic students and larger numbers of others making use of new technologies but in ways that did not fully correspond with many of the expectations built into the Net generation and Digital Natives theses