Foreign doctors and hospital quality: Evidence from the English NHS

IF 2.2 2区经济学 Q2 ECONOMICS

Labour Economics Pub Date : 2025-03-11 DOI:10.1016/j.labeco.2025.102707

Ioannis Laliotis

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Abstract

This paper examines the relationship between hospital quality and the share of foreign doctors in the English NHS. Baseline findings suggest that heart attack mortality is higher in hospitals with greater shares of foreign doctors practising relevant specialties. Robustness tests and heterogeneity analyses indicate that this association is specific to Acute Myocardial Infraction (AMI) treatment and is driven by hospitals that are smaller, of lower-quality, and ill-equipped to provide optimal care. When explicitly considering for treatment type, AMI mortality does not vary with the share of foreign AMI specialists in hospitals capable to access certain treatment technologies within 150 min. Overall, the results suggest that higher AMI mortality is not caused by foreign-trained AMI doctors but instead reflects structural challenges and resource-driven hiring patterns in constrained hospitals, which tend to rely more heavily on foreign doctors to mitigate worse outcomes. Further research is needed to better understand the allocation of foreign doctors to underperforming hospitals and its implications for healthcare delivery.

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本文研究了英国国家医疗服务体系中医院质量与外籍医生比例之间的关系。基线研究结果表明，在相关专科外国医生比例较高的医院，心脏病发作死亡率较高。稳健性测试和异质性分析表明，这种关联只与急性心肌梗死（AMI）治疗有关，而且是由规模较小、质量较差、没有能力提供最佳治疗的医院造成的。当明确考虑治疗类型时，急性心肌梗死死亡率并不随医院中能够在 150 分钟内获得特定治疗技术的外国急性心肌梗死专家比例而变化。总之，研究结果表明，急性心肌梗死死亡率较高并不是由外国培训的急性心肌梗死医生造成的，而是反映了受限医院的结构性挑战和资源驱动型雇佣模式，这些医院倾向于更多地依赖外国医生来缓解较差的结果。要更好地了解外国医生被分配到表现不佳医院的情况及其对医疗服务的影响，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Labour Economics ECONOMICS-

CiteScore

3.60

自引率

8.30%

发文量

142

期刊介绍： Labour Economics is devoted to publishing research in the field of labour economics both on the microeconomic and on the macroeconomic level, in a balanced mix of theory, empirical testing and policy applications. It gives due recognition to analysis and explanation of institutional arrangements of national labour markets and the impact of these institutions on labour market outcomes.