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The life‐saving effect of hospital proximity

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  • Paola Bertoli
  • Veronica Grembi

Abstract

We provide a new assessment of the effect of hospital proximity in an emergency situation—road‐traffic accidents—exploiting the exogenous variation in the proximity to cities that are legally allowed to have a hospital on the basis of their population size. Our instrumental variable results show that a one‐standard‐deviation increase in the distance to the nearest hospital (5 km) raises the fatality rate by 13.84% at the sample average. This figure is equal to 0.92 additional deaths per 100 accidents. We show that both ordinary least squares and difference‐in‐differences estimates, common approaches in the literature, provide a downward‐biased measure of the true effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity is more important when the level of road safety is low, when emergency services are less responsive, and when the nearest hospital has relatively low quality standards.

Suggested Citation

  • Paola Bertoli & Veronica Grembi, 2017. "The life‐saving effect of hospital proximity," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 78-91, September.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:s2:p:78-91
    DOI: 10.1002/hec.3571
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    Cited by:

    1. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    2. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    3. Sofia Amaral‐Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1050-1064, September.
    4. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    5. Sofia Amaral-Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities in Italy," CEIS Research Paper 342, Tor Vergata University, CEIS, revised 08 May 2015.
    6. Kollerup, Anna, 2022. "Worth the trip? The effect of hospital clinic closures for patients undergoing scheduled surgery," Social Science & Medicine, Elsevier, vol. 314(C).
    7. Cristina Borra & Jerònia Pons-Pons & Margarita Vilar-Rodríguez, 2020. "Austerity, healthcare provision, and health outcomes in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 409-423, April.
    8. Paola Bertoli & Veronica Grembi, 2017. "Exploring the Nexus between Certainty in Injury Compensation and Treatment Selection," CERGE-EI Working Papers wp603, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    9. Bertoli, Paola & Grembi, Veronica & Vall Castellò, Judit, 2018. "Not all silver lining? The Great Recession and road traffic accidents," Regional Science and Urban Economics, Elsevier, vol. 70(C), pages 274-288.

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    More about this item

    JEL classification:

    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation
    • I10 - Health, Education, and Welfare - - Health - - - General
    • R41 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Transportation Economics - - - Transportation: Demand, Supply, and Congestion; Travel Time; Safety and Accidents; Transportation Noise

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