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Choice of hospital and long-distances: Evidence from Italy

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  • Balia, Silvia
  • Brau, Rinaldo
  • Moro, Daniela

Abstract

Long-distance hospitalizations may represent an important phenomenon, especially with severe pathologies. In this work, we investigate patients’ elective admissions for cancers of the digestive system distinguishing between “local” hospitals (located in the region of residence) and “distant” hospitals (located in long-distances non-boundary regions). We model patient mobility towards alternative hospitals as a discrete choice process determined by geographical distance, clinical quality and other hospital-level characteristics and control for patients’ heterogeneity. We exploit data on admissions of patients residing in insular Italy, occurred in 2013 either locally or in central-northern hospitals, and estimate a willingness to travel of at least 14 ​km to be cured in a distant hospital for a quality increase from the 75th to the 25th percentile. Higher values are found for younger and more educated patients. Clinical quality does not affect the choice of local hospitals. Hospital choice significantly depends on characteristics that proxy hospital attractiveness, with differences between local and distant providers: commitment to research and private ownership show a positive role only for the latter.

Suggested Citation

  • Balia, Silvia & Brau, Rinaldo & Moro, Daniela, 2020. "Choice of hospital and long-distances: Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 81(C).
    • Handle: RePEc:eee:regeco:v:81:y:2020:i:c:s0166046219302522
    DOI: 10.1016/j.regsciurbeco.2019.103502
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    References listed on IDEAS

    as
    1. Avdic, Daniel & Lundborg, Petter & Vikström, Johan, 2019. "Estimating returns to hospital volume: Evidence from advanced cancer surgery," Journal of Health Economics, Elsevier, vol. 63(C), pages 81-99.
    2. Joan Costa-Font & Gilberto Turati, 2018. "Regional healthcare decentralization in unitary states: equal spending, equal satisfaction?," Regional Studies, Taylor & Francis Journals, vol. 52(7), pages 974-985, July.
    3. Avdic, Daniel, 2016. "Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden," Journal of Health Economics, Elsevier, vol. 48(C), pages 44-60.
    4. Amitabh Chandra & Amy Finkelstein & Adam Sacarny & Chad Syverson, 2016. "Health Care Exceptionalism? Performance and Allocation in the US Health Care Sector," American Economic Review, American Economic Association, vol. 106(8), pages 2110-2144, August.
    5. Silvia Balia & Rinaldo Brau & Emanuela Marrocu, 2018. "Interregional patient mobility in a decentralized healthcare system," Regional Studies, Taylor & Francis Journals, vol. 52(3), pages 388-402, March.
    6. Walter Beckert & Mette Christensen & Kate Collyer, 2012. "Choice of NHS‐funded Hospital Services in England," Economic Journal, Royal Economic Society, vol. 122(560), pages 400-417, May.
    7. Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July.
    8. Giuseppe Moscelli & Luigi Siciliani & Nils Gutacker & Hugh Gravelle, 2016. "Location, quality and choice of hospital: Evidence from England 2002/3 - 2012/13," Working Papers 123cherp, Centre for Health Economics, University of York.
    9. repec:ecj:econjl:v:122:y:2012:i::p:400-417 is not listed on IDEAS
    10. Chou, Shin-Yi & Deily, Mary E. & Li, Suhui & Lu, Yi, 2014. "Competition and the impact of online hospital report cards," Journal of Health Economics, Elsevier, vol. 34(C), pages 42-58.
    11. 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.
    12. Paolo Berta & Gianmaria Martini & Francesco Moscone & Giorgio Vittadini, 2016. "The association between asymmetric information, hospital competition and quality of healthcare: evidence from Italy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 907-926, October.
    13. Martin Gaynor & Harald Seider & William B. Vogt, 2005. "The Volume–Outcome Effect, Scale Economies, and Learning-by-Doing," American Economic Review, American Economic Association, vol. 95(2), pages 243-247, May.
    14. Moscelli, Giuseppe & Siciliani, Luigi & Gutacker, Nils & Gravelle, Hugh, 2016. "Location, quality and choice of hospital: Evidence from England 2002–2013," Regional Science and Urban Economics, Elsevier, vol. 60(C), pages 112-124.
    15. Yao Lu & David J. G. Slusky, 2019. "The Impact of Women's Health Clinic Closures on Fertility," American Journal of Health Economics, MIT Press, vol. 5(3), pages 334-359, Summer.
    16. Arne Risa Hole, 2006. "Small-sample properties of tests for heteroscedasticity in the conditional logit model," Economics Bulletin, AccessEcon, vol. 3(18), pages 1-14.
    17. John A. Romley & Dana P. Goldman, 2011. "How Costly is Hospital Quality? A Revealed‐Preference Approach," Journal of Industrial Economics, Wiley Blackwell, vol. 59(4), pages 578-608, December.
    18. Pope, Devin G., 2009. "Reacting to rankings: Evidence from "America's Best Hospitals"," Journal of Health Economics, Elsevier, vol. 28(6), pages 1154-1165, December.
    19. repec:wly:hlthec:v:26:y:2017:i::p:92-105 is not listed on IDEAS
    20. Rosella Levaggi & Roberto Zanola, 2004. "Patients' migration across regions: the case of Italy," Applied Economics, Taylor & Francis Journals, vol. 36(16), pages 1751-1757.
    21. Varkevisser, Marco & van der Geest, Stéphanie A. & Schut, Frederik T., 2012. "Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands," Journal of Health Economics, Elsevier, vol. 31(2), pages 371-378.
    22. Gutacker, Nils & Siciliani, Luigi & Moscelli, Giuseppe & Gravelle, Hugh, 2016. "Choice of hospital: Which type of quality matters?," Journal of Health Economics, Elsevier, vol. 50(C), pages 230-246.
    23. Fiva, Jon H. & Hægeland, Torbjørn & Rønning, Marte & Syse, Astri, 2014. "Access to treatment and educational inequalities in cancer survival," Journal of Health Economics, Elsevier, vol. 36(C), pages 98-111.
    24. Fattore, Giovanni & Petrarca, Giuseppina & Torbica, Aleksandra, 2014. "Traveling for care: Inter-regional mobility for aortic valve substitution in Italy," Health Policy, Elsevier, vol. 117(1), pages 90-97.
    25. Yao Lu & David J. G. Slusky, 2016. "The Impact of Women's Health Clinic Closures on Preventive Care," American Economic Journal: Applied Economics, American Economic Association, vol. 8(3), pages 100-124, July.
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    More about this item

    Keywords

    Hospital choice; Access to care; Distance; Quality of care; Patient mobility;

    JEL classification:

    • C25 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions; Probabilities
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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