2. Do hospital mergers reduce waiting times? Theory and evidence from the English NHS

2. Do hospital mergers reduce waiting times? Theory and evidence from the English NHS

Cirulli, V., Marini, G., Marini, M. A., & Straume, O. R. (2025). Do hospital mergers reduce waiting times? Theory and evidence from the English NHS. Journal of Economic Behavior and Organization, 238. https://doi.org/10.1016/j.jebo.2025.107196


The study examines both theoretically and empirically the impact of hospital mergers on waiting times in health care markets with regulated prices, using the English National Health Service (NHS) as a case study. The theoretical model adopts a spatial framework in which patients choose hospitals based on travel distance and waiting times, while hospitals maximize a weighted objective combining profits and patient welfare. The model predicts an ambiguous overall effect of mergers, as they internalize opposing competitive forces: altruistic competition, which may increase waiting times by attracting more patients, and profit-oriented competition, which may reduce waiting times by discouraging the treatment of unprofitable patients. Cost synergies can further lower waiting times when hospitals are sufficiently profit-oriented. Empirically, using 19 years of NHS panel data and a difference-in-differences approach, the study finds that mergers increase waiting times on average by 41%. However, effects are heterogeneous: mergers involving Foundation Trusts reduce waiting times substantially, while mergers among more altruistic hospitals increase them.

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Episoder(108)

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