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

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Author Info
Moscone, Francesco
Tosetti, Elisa
Vittadini, Giorgio

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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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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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Related research
Keywords: health care; social interaction; quality;

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Find related papers by JEL classification:
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
H00 - Public Economics - - General - - - General
C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models

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  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. [Downloadable!] (restricted)
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  3. 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. [Downloadable!] (restricted)
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  5. repec:att:wimass:192031 is not listed on IDEAS
  6. 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. [Downloadable!]
  7. 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.
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  10. Deri, Catherine, 2005. "Social networks and health service utilization," Journal of Health Economics, Elsevier, vol. 24(6), pages 1076-1107, November. [Downloadable!] (restricted)
  11. Daniel Birke, 2009. "The Economics Of Networks: A Survey Of The Empirical Literature," Journal of Economic Surveys, Blackwell Publishing, vol. 23(4), pages 762-793, 09. [Downloadable!] (restricted)
  12. William A. Brock & Steven N. Durlauf, 2003. "Multinomial Choice with Social Interactions," NBER Technical Working Papers 0288, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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