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Spatial effects in hospital expenditures: A district level analysis

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  • Matteo Lippi Bruni
  • Irene Mammi

Abstract

We use spatial econometric methods to analyse spillovers in hospital expenditures across Health Districts of the Emilia‐Romagna Region (Italy). We estimate spatial models that allow for global spillovers and distinguish between the expenditures associated with potentially inappropriate hospitalizations and those associated with complex medical procedures. We also investigate the relative contribution of geographical and institutional proximity in explaining spatial dependence, by explicitly modelling different connectivity structures and exploiting them to build alternative spatial weight matrices. We find that interactions largely differ between types of expenditures, with positive spatial effects for potentially inappropriate admissions, the effect being generally not significant for high‐complexity expenditure. Relying on the estimated direct and indirect effects, we also test for the presence of spatial spillovers across districts. Finally, the paper draws policy implications for the public health planner.

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  • Matteo Lippi Bruni & Irene Mammi, 2017. "Spatial effects in hospital expenditures: A district level analysis," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 63-77, September.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:s2:p:63-77
    DOI: 10.1002/hec.3558
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    3. Vidoli, Francesco & Pignataro, Giacomo & Benedetti, Roberto, 2022. "Identification of spatial regimes of the production function of Italian hospitals through spatially constrained cluster-wise regression," Socio-Economic Planning Sciences, Elsevier, vol. 82(PA).
    4. Gianluca Fiorentini & Silvana Robone & Rossella Verzulli, 2018. "How do hospital‐specialty characteristics influence health system responsiveness? An empirical evaluation of in‐patient care in the Italian region of Emilia‐Romagna," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 266-281, February.
    5. Lippi Bruni, Matteo & Ugolini, Cristina & Verzulli, Rossella, 2021. "Should I wait or should I go? Travelling versus waiting for better healthcare," Regional Science and Urban Economics, Elsevier, vol. 89(C).
    6. Kiziltan, Mustafa, 2021. "Water-energy nexus of Turkey’s municipalities: Evidence from spatial panel data analysis," Energy, Elsevier, vol. 226(C).
    7. Sebastien Bourdin & Sevgi Eda Tuzcu & Esra Satıcı, 2023. "Explaining COVID‐19 vaccine uptake: A spatial sociodemographic study in Turkey," Papers in Regional Science, Wiley Blackwell, vol. 102(2), pages 307-329, April.
    8. Sorinel Toderaş Siretean & Veronica Grosu & Anamaria-Geanina Macovei & Simona Maria Brînzaru, 2023. "Optimising Expenditure In Hospital Units," European Journal of Accounting, Finance & Business, "Stefan cel Mare" University of Suceava, Romania - Faculty of Economics and Public Administration, West University of Timisoara, Romania - Faculty of Economics and Business Administration, vol. 11(1), pages 139-146, February.
    9. Francetic, Igor & Meacock, Rachel & Sutton, Matt, 2024. "Free-for-all: Does crowding impact outcomes because hospital emergency departments do not prioritise effectively?," Journal of Health Economics, Elsevier, vol. 95(C).
    10. Cavalieri, M.; Di Caro, P.; Guccio, C.; Lisi, D.;, 2017. "Does neighbour’s grass matter? Exploring spatial dependent heterogeneity in technical efficiency of Italian hospitals," Health, Econometrics and Data Group (HEDG) Working Papers 17/13, HEDG, c/o Department of Economics, University of York.
    11. Cavalieri, Marina & Di Caro, Paolo & Guccio, Calogero & Lisi, Domenico, 2020. "Does neighbours' grass matter? Testing spatial dependent heterogeneity in technical efficiency of Italian hospitals," Social Science & Medicine, Elsevier, vol. 265(C).

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • R12 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - General Regional Economics - - - Size and Spatial Distributions of Regional Economic Activity; Interregional Trade (economic geography)
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models

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