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Spatial disparities in hospital performances

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  • Gobillon, Laurent
  • Milcent, Carine

Abstract

Spatial disparities in mortality can result from spatial di¤erences in patient characteristics, treatments, hospital characteristics, and local healthcare market structure. To distinguish between these explanatory factors, we estimate a flexible duration model on stays in hospital for a heart attack using a French exhaustive dataset. Over the 1998-2003 period, the raw disparities in the propensity to die within 15 days between the extreme regions reaches 80 %. It decreases to 47% after taking into account the patients' characteristics and their treatments. We conduct a variance analysis to explain regional disparities in mortality. Whereas spatial variations in the use of innovative treatments play the most important role, spatial di¤erences in the local concentration of patients also play a significant role.

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Bibliographic Info

Paper provided by CEPREMAP in its series CEPREMAP Working Papers (Docweb) with number 1007.

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Length: 57 pages
Date of creation: Jun 2010
Date of revision:
Handle: RePEc:cpm:docweb:1007

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Keywords: Spatial Health Disparities; Economic Geography; Stratified Duration Model;

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References

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  1. Gilles Duranton & Vassilis Monastiriotis, 2000. "Mind the gaps: the evolution of regional inequalities in the UK, 1982-1997," LSE Research Online Documents on Economics 20135, London School of Economics and Political Science, LSE Library.
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  7. Brigitte Dormont & Carine Milcent, 2010. "Innovation Diffusion under Budget Constraints: Microeconometric Evidence on Heart Attack in France," NBER Chapters, in: Contributions in Memory of Zvi Griliches, pages 697-726 National Bureau of Economic Research, Inc.
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Cited by:
  1. Badi H. Baltagi & Yin-Fang Yen, 2014. "Hospital Treatment Rates and Spill-Over Effects: Does Ownership Matter?," Center for Policy Research Working Papers 165, Center for Policy Research, Maxwell School, Syracuse University.
  2. MORIKAWA Masayuki, 2010. "Economies of Scale and Hospital Productivity: An empirical analysis of medical area level panel data," Discussion papers 10050, Research Institute of Economy, Trade and Industry (RIETI).

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