Research 📝

[Working Paper]: The Effect of General Practice Mergers on Quality in England Revise & Resubmit, Journal of Health Economics (with Zhaocheng Zhang) Abstract: The primary care market has witnessed a growing trend of provider consolidation through mergers and acquisitions, yet the implications of this concentration remain uncertain. This study addresses this gap by providing the first empirical evidence on the effects of provider mergers on quality using evidence from the English primary care market. By analyzing all provider mergers from 2014 to 2018, we find predominantly negative effects of mergers on quality. Clinical quality does not change at best, and patient satisfaction decreases dramatically. Notably, the impact on quality varies based on the size of the general practices involved. Mergers between large general practices show a detrimental impact on quality, while mergers between small general practices may yield quality benefits. Additionally, there is no difference in the quality impact between mergers involving parties in the same geographical market and those in different markets. An exploration of the mechanism reveals that incompetency, rather than changes in market concentration, drives the observed decline in quality following mergers. Presentation: EEA-ESEM 2023, Barcelona; Annual Trans-Atlantic Doctoral Conference 2023, London Business School; University of Cambridge
: Competition and Asymmetric Pass-Through Under Review (with Christos Genakos and Mario Pagliero) Abstract: We study the pass-through to retail prices of four major changes in taxes for petroleum products (three increases and one subsequent decrease). We use daily pricing data from gas stations on small Greek islands, which define isolated markets with different number of competitors. The pass-through of the tax increases sharply grows with competition, but that of the tax decrease does not vary with competition. This generates a large asymmetry in pass-through, which is on average 5 times higher for the tax increases. We also find a significant asymmetry in the speed of price adjustments. Media Coverage: VoxEU Column
: Privatisation and Doctor Turnover: Evidence from the English Primary Care Market Under Review Abstract: The privatization of healthcare services has become a significant feature in many countries, yet its impact on healthcare professionals, particularly doctor turnover, remains underexplored. By constructing a novel dataset that tracks individual physician movements across general practices in England from 2013 to 2021, this paper provides the first empirical evidence on the relationship between private ownership and doctor turnover in the primary care market. We find that private ownership increases the likelihood of a doctor leaving the practice by approximately 3 to 4 percentage points. The effect is particularly pronounced among younger, less experienced doctors and those internationally trained, while no significant differences are observed between male and female doctors. Further exploration of the mechanism shows that the presence of physicians in leadership roles does not mitigate the turnover effect. Instead, higher turnover rates are concentrated in commercially owned practices with weaker performance. These results provide valuable insights for policymakers seeking to stabilize the healthcare workforce in an increasingly privatized primary care system.

[Work in Progress]: Data Privacy and APP Performance: Impact of ATT on Mobile Gaming (with Christos Genakos and Nestor Duch-brown)
: The Corporatization of Primary Care: Evidence from England (with Stefan Scholtes)