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Social Interaction in Patients'�Hospital Choice: Evidences from Italy

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  • Moscone, Francesco
  • Tosetti, Elisa
  • Vittadini, Giorgio

Abstract

In this paper we study the influence of social interaction on patients' hospital choice and its relationship with quality delivered by hospitals, using Italian data. We explore the impact on individual choices of a set of variables such as travel distance, individual- and hospital-specific characteristics, as well as a variable capturing the effect of the neighbourhood. The richness of our data allows us to disentangle contextual effects from the influence of information sharing on patients' hospital choices. We then use this framework to assess how such interaction is related to clinical hospital quality. Results show that network effect plays an important role in hospital choices, although it is less relevant for larger hospitals. Another empirical finding is the existence of a negative relationship between the degree of interaction among individuals and the quality delivered by hospitals. The absence of a source of information on the quality of hospitals accessible to all individuals, such as guidelines or star ratings, exacerbates the importance of information gathered locally in hospital choices, which may result in a lower degree of competition among hospitals and lower quality.

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Bibliographic Info

Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 17783.

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Date of creation: 09 Oct 2009
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Handle: RePEc:pra:mprapa:17783

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Keywords: health care; social interaction; quality;

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References

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  1. Edward E. Glaeser & Bruce Sacerdote & Jose A. Scheinkman, 1995. "Crime and Social Interactions," Harvard Institute of Economic Research Working Papers 1738, Harvard - Institute of Economic Research.
  2. Brock, William A. & Durlauf, Steven N., 2001. "Interactions-based models," Handbook of Econometrics, in: J.J. Heckman & E.E. Leamer (ed.), Handbook of Econometrics, edition 1, volume 5, chapter 54, pages 3297-3380 Elsevier.
  3. Berta, P & Callea, G & Martini, G & Vittadini, G, 2009. "The effects of upcoding, cream skimming and readmissions on the Italian hospitals efficiency: a population–based investigation," MPRA Paper 17671, University Library of Munich, Germany.
  4. Daniel Birke, 2009. "The Economics Of Networks: A Survey Of The Empirical Literature," Journal of Economic Surveys, Wiley Blackwell, vol. 23(4), pages 762-793, 09.
  5. Federico Revelli, 2004. "Performance Rating and Yardstick Competition in Social Service Provision," CESifo Working Paper Series 1270, CESifo Group Munich.
  6. Deri, Catherine, 2005. "Social networks and health service utilization," Journal of Health Economics, Elsevier, vol. 24(6), pages 1076-1107, November.
  7. William A. Brock & Steven N. Durlauf, 2003. "Multinomial Choice with Social Interactions," NBER Technical Working Papers 0288, National Bureau of Economic Research, Inc.
  8. Dana Goldman & John A. Romley, 2008. "Hospitals As Hotels: The Role of Patient Amenities in Hospital Demand," NBER Working Papers 14619, National Bureau of Economic Research, Inc.
  9. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 577-615, May.
  10. Jonathan Skinner & Douglas Staiger, 2005. "Technology Adoption From Hybrid Corn to Beta Blockers," NBER Working Papers 11251, National Bureau of Economic Research, Inc.
  11. Patrick S. Romano & Ryan Mutter, 2004. "The Evolving Science of Quality Measurement for Hospitals: Implications for Studies of Competition and Consolidation," International Journal of Health Care Finance and Economics, Springer, vol. 4(2), pages 131-157, 06.
  12. Tay, Abigail, 2003. " Assessing Competition in Hospital Care Markets: The Importance of Accounting for Quality Differentiation," RAND Journal of Economics, The RAND Corporation, vol. 34(4), pages 786-814, Winter.
  13. Aizer, Anna & Currie, Janet, 2004. "Networks or neighborhoods? Correlations in the use of publicly-funded maternity care in California," Journal of Public Economics, Elsevier, vol. 88(12), pages 2573-2585, December.
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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.

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