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Ownership and hospital behaviour: Employment and local unemployment

Clark, Andrew E., Milcent, Carine (2018) Ownership and hospital behaviour: Employment and local unemployment. Social Science and Medicine, 202 . pp. 151-161. ISSN 0277-9536. (doi:10.1016/j.socscimed.2018.02.027) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
http://dx.doi.org/10.1016/j.socscimed.2018.02.027

Abstract

In this paper, we address two issues: i) how hospital employment changes with local unemployment, according to the type of hospital ownership, and ii) whether this relationship changed after the implementation of a pro-competitive reform that made hospitals more similar. A 2006–2010 French panel of 1695 hospitals over five waves allows us to consider within-hospital employment changes. We first find that higher local unemployment is associated with greater employment in State-owned hospitals, but not for any other hospital ownership type: French local authorities then seem to respond to depressed local labour markets by increasing employment in State-owned hospitals. After the full implementation of the pro-competitive reform hospital funding became based only on activity and no longer on some historical budget. Theoretically, the new reimbursement system should break the relationship between public-hospital employment and local unemployment. Our results reveal that the reform worked as expected in less-deprived areas: reducing employment and eliminating the correlation between local unemployment and State-owned hospital employment. However, in higher-unemployment areas, public-hospital employment remains counter-cyclical. Poor local labour-market health then seems to trump financial incentives in determining employment in public hospitals.

Item Type: Article
DOI/Identification number: 10.1016/j.socscimed.2018.02.027
Uncontrolled keywords: competition (economics); hospital sector; labor market; local government; ownership; state owned enterprise; unemployment, article; behavior; budget; competition; France; funding; market; public hospital; reimbursement; unemployment, France
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > Kent Business School > Industrial Relations/HRM
Depositing User: Andrew Clark
Date Deposited: 21 Sep 2018 10:03 UTC
Last Modified: 15 Jul 2019 08:07 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/69173 (The current URI for this page, for reference purposes)
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