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Spatial disparities in hospital performance

  • Laurent Gobillon
  • Carine Milcent

Spatial disparities in mortality can result from spatial differences in patientcharacteristics, treatments, hospital characteristics, and local healthcare marketstructure. To distinguish between these explanatory factors, we estimate a fexibleduration model on stays in hospital for a heart attack using a French exhaustivedataset. Over the 1998-2003 period, the raw disparities in the propensity to die within15 days between the extreme regions reaches 80%. It decreases to 47% after takinginto account the patients' characteristics and their treatments. We conduct a varianceanalysis to explain regional disparities in mortality. Whereas spatial variations in theuse of innovative treatments play the most important role, spatial differences in thelocal concentration of patients also play a significant role.

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Article provided by Oxford University Press in its journal Journal of Economic Geography.

Volume (Year): 13 (2013)
Issue (Month): 6 (November)
Pages: 1013-1040

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Handle: RePEc:oup:jecgeo:v:13:y:2013:i:6:p:1013-1040
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