Subjective and objective quality and choice of hospital: evidence from maternal care services in Germany

Daniel Avdic, Giuseppe Moscelli, Adam Pilny, Ieva Sriubaite

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4 Citations (Scopus)


We study patient choice of healthcare provider based on both objective and subjective quality measures in the context of maternal care hospital services in Germany. Objective measures are obtained from publicly reported clinical indicators, while subjective measures are based on satisfaction scores from a large and nationwide patient survey. We merge both quality metrics to detailed hospital discharge records and quantify the additional distance expectant mothers are willing to travel to give birth in maternity clinics with higher reported quality. Our results reveal that patients are on average willing to travel 0.1–2.7 additional kilometers for a one standard deviation increase in quality. Patients respond to both objective and subjective quality measures, suggesting that patient satisfaction scores may constitute important complements to clinical indicators when choosing provider.

Original languageEnglish
Article number102229
Number of pages19
JournalJournal of Health Economics
Publication statusPublished - 1 Dec 2019


  • Competition
  • Maternal care
  • Provider choice
  • Quality

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