IDEAS home Printed from https://ideas.repec.org/p/bai/series/series_wp_01-2024.html
   My bibliography  Save this paper

Monetary flows for health mobility: The Italian NHS from a network perspective

Author

Listed:
  • Giovanni Carnazza

    (University of Pisa)

  • Raffaele Lagravinese

    (University of Bari)

  • Paolo Liberati

    (Roma Tre University)

  • Irene Torrini

    (Bocconi University)

Abstract

This study investigates the dynamics of health care mobility in Italy, where citizens have the freedom to access medical treatment across regions. More than half a million patients, primarily from the Southern regions, engage in healthcare mobility, resulting in a total expenditure of €3.7 billion in 2019. Leveraging a unique dataset spanning from 2002 to 2019, this research examines financial transactions, utilizes network analysis, and identifies influencing factors through a gravity model. Socioeconomic disparities and the availability of specialized services are key drivers of this mobility. Regions with higher healthcare quality and the presence of private licensed hospitals attract a larger number of patients. This study offers valuable insights into the intricacies of interregional healthcare mobility, which can inform healthcare policy and promote regional equity considerations.

Suggested Citation

  • Giovanni Carnazza & Raffaele Lagravinese & Paolo Liberati & Irene Torrini, 2024. "Monetary flows for health mobility: The Italian NHS from a network perspective," SERIES 01-2024, Dipartimento di Economia e Finanza - Università degli Studi di Bari "Aldo Moro", revised Mar 2024.
    • Handle: RePEc:bai:series:series_wp_01-2024
    as

    Download full text from publisher

    File URL: http://www.seriesworkingpapers.it/RePEc/bai/series/SERIES_WP_01-2024.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Daniele Fabbri & Silvana Robone, 2010. "The geography of hospital admission in a national health service with patient choice," Health Economics, John Wiley & Sons, Ltd., vol. 19(9), pages 1029-1047, September.
    2. Cristian Barra & Raffaele Lagravinese & Roberto Zotti, 2022. "Exploring hospital efficiency within and between Italian regions: new empirical evidence," Journal of Productivity Analysis, Springer, vol. 57(3), pages 269-284, June.
    3. Charles M. Tiebout, 1956. "A Pure Theory of Local Expenditures," Journal of Political Economy, University of Chicago Press, vol. 64(5), pages 416-416.
    4. Cappelli, Federica & Carnazza, Giovanni & Vellucci, Pierluigi, 2023. "Crude oil, international trade and political stability: Do network relations matter?," Energy Policy, Elsevier, vol. 176(C).
    5. Zhang, Hai-Ying & Ji, Qiang & Fan, Ying, 2014. "Competition, transmission and pattern evolution: A network analysis of global oil trade," Energy Policy, Elsevier, vol. 73(C), pages 312-322.
    6. Raffaele Lagravinese, 2015. "Economic crisis and rising gaps North–South: evidence from the Italian regions," Cambridge Journal of Regions, Economy and Society, Cambridge Political Economy Society, vol. 8(2), pages 331-342.
    7. De Luca, Giacomo & Lisi, Domenico & Martorana, Marco & Siciliani, Luigi, 2021. "Does higher Institutional Quality improve the Appropriateness of Healthcare Provision?," Journal of Public Economics, Elsevier, vol. 194(C).
    8. Massimo Bordignon & Silvia Coretti & Massimiliano Piacenza & Gilberto Turati, 2020. "Hardening subnational budget constraints via administrative subordination: The Italian experience of recovery plans in regional health services," Health Economics, John Wiley & Sons, Ltd., vol. 29(11), pages 1378-1399, November.
    9. Perna, Roberta & Cruz-Martínez, Gibrán & Moreno Fuentes, Francisco Javier, 2022. "Patient mobility within national borders. Drivers and politics of cross-border healthcare agreements in the Spanish decentralized system," Health Policy, Elsevier, vol. 126(11), pages 1187-1193.
    10. Adolph, Christopher & Greer, Scott L. & Massard da Fonseca, Elize, 2012. "Allocation of authority in European health policy," Social Science & Medicine, Elsevier, vol. 75(9), pages 1595-1603.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. M. Alessandra Antonelli & Giorgia Marini, 2025. "Do institutions matter for citizens’ health status? Empirical evidence from Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 26(1), pages 95-115, February.
    2. Elenka Brenna & Federico Spandonaro, 2014. "Does federalism induce patients’ mobility across regions? Evidence from the Italian experience," DISCE - Working Papers del Dipartimento di Economia e Finanza def009, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    3. Massimo Finocchiaro Castro & Calogero Guccio & Domenica Romeo & Francesco Vidoli, 2025. "How does institutional quality affect the efficiency of local government? An assessment of Italian municipalities," Economia Politica: Journal of Analytical and Institutional Economics, Springer;Fondazione Edison, vol. 42(2), pages 569-597, July.
    4. repec:ctc:serie1:def9 is not listed on IDEAS
    5. Sergio Beraldo & Michela Collaro & Immacolata Marino, 2020. "Do Harder Local Budget Constraints Affect Patient Mobility?," CSEF Working Papers 580, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy.
    6. Berta, Paolo & Guerriero, Carla & Levaggi, Rosella, 2021. "Hospitals’ strategic behaviours and patient mobility: Evidence from Italy," Socio-Economic Planning Sciences, Elsevier, vol. 77(C).
    7. Cristian Barra & Raffaele Lagravinese & Roberto Zotti, 2022. "Exploring hospital efficiency within and between Italian regions: new empirical evidence," Journal of Productivity Analysis, Springer, vol. 57(3), pages 269-284, June.
    8. Guccio, Calogero & Pignataro, Giacomo & Romeo, Domenica & Vidoli, Francesco, 2024. "Is austerity good for efficiency, at least? A counterfactual assessment for the Italian NHS," Socio-Economic Planning Sciences, Elsevier, vol. 92(C).
    9. Paolo Berta & Carla Guerriero & Rosella Levaggi, 2018. "The dark side of fiscal federalism:evidence from hospital care in Italy," Working papers 72, Società Italiana di Economia Pubblica.
    10. Emanuela Marrocu & Silvia Balia & Rinaldo Brau, 2016. "A spatial analysis of inter-regional patient mobility in Italy," ERSA conference papers ersa16p127, European Regional Science Association.
    11. Salih Ozgur SARICA, 2014. "Regional Economic Growth. Socio-Economic Disparities among Counties," Journal of Economic Development, Environment and People, Alliance of Central-Eastern European Universities, vol. 3(4), pages 25-36, December.
    12. Christopher Dick-Sagoe & Ernest Ngeh Tingum & Peter Asare-Nuamah & Denis N. Yuni & Nicholas Baidoo, 2025. "Central transfers and incentives to collect local revenue among the Central Region of Ghana’s local government officials: analysing the flypaper effect," Humanities and Social Sciences Communications, Palgrave Macmillan, vol. 12(1), pages 1-12, December.
    13. Marina Capparucci & Emanuela Ghignoni & Alina Verashchagina & Natalia Vorozhbit, 2015. "The Drivers of Innovation in the Italian Manufacturing Sector," Economia & lavoro, Carocci editore, issue 3, pages 111-128.
    14. Sandy Fréret & Denis Maguain, 2017. "The effects of agglomeration on tax competition: evidence from a two-regime spatial panel model on French data," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 24(6), pages 1100-1140, December.
    15. Hilber, Christian A.L., 2010. "New housing supply and the dilution of social capital," Journal of Urban Economics, Elsevier, vol. 67(3), pages 419-437, May.
    16. Natalie Brady, 2002. "Striking a Balance: Centralised and Decentralised Decisions in Government," Treasury Working Paper Series 02/15, New Zealand Treasury.
    17. Patrick Bayer & Fernando Ferreira & Robert McMillan, 2007. "A Unified Framework for Measuring Preferences for Schools and Neighborhoods," Journal of Political Economy, University of Chicago Press, vol. 115(4), pages 588-638, August.
    18. Hjerppe, Reino & Berghall, Pii Elina, "undated". "The Urban Challenge," WIDER Working Papers 295315, United Nations University, World Institute for Development Economic Research (UNU-WIDER).
    19. Tidiane Ly, 2018. "Sub-metropolitan tax competition with household and capital mobility," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 25(5), pages 1129-1169, October.
    20. Jean Gabszewicz & Ornella Tarola & Skerdilajda Zanaj, 2016. "Migration, wages and income taxes," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 23(3), pages 434-453, June.
    21. Zodrow, George R, 2003. "Tax Competition and Tax Coordination in the European Union," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 10(6), pages 651-671, November.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bai:series:series_wp_01-2024. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Annalisa Vinella (email available below). General contact details of provider: https://edirc.repec.org/data/debarit.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.