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Social Interaction in Patients'�Hospital Choice: Evidences from Italy

  • Moscone, Francesco
  • Tosetti, Elisa
  • Vittadini, Giorgio

In this paper we study the influence of social interaction on patients' hospital choice and its relationship with quality delivered by hospitals, using Italian data. We explore the impact on individual choices of a set of variables such as travel distance, individual- and hospital-specific characteristics, as well as a variable capturing the effect of the neighbourhood. The richness of our data allows us to disentangle contextual effects from the influence of information sharing on patients' hospital choices. We then use this framework to assess how such interaction is related to clinical hospital quality. Results show that network effect plays an important role in hospital choices, although it is less relevant for larger hospitals. Another empirical finding is the existence of a negative relationship between the degree of interaction among individuals and the quality delivered by hospitals. The absence of a source of information on the quality of hospitals accessible to all individuals, such as guidelines or star ratings, exacerbates the importance of information gathered locally in hospital choices, which may result in a lower degree of competition among hospitals and lower quality.

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Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 17783.

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Date of creation: 09 Oct 2009
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Handle: RePEc:pra:mprapa:17783
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  1. Berta, Paolo & Callea, Giuditta & Martini, Gianmaria & Vittadini, Giorgio, 2010. "The effects of upcoding, cream skimming and readmissions on the Italian hospitals efficiency: A population-based investigation," Economic Modelling, Elsevier, vol. 27(4), pages 812-821, July.
  2. Edward L. Glaeser & Bruce Sacerdote & Jose A. Scheinkman, 1995. "Crime and Social Interactions," NBER Working Papers 5026, National Bureau of Economic Research, Inc.
  3. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, MIT Press, vol. 115(2), pages 577-615, May.
  4. Brock,W.A. & Durlauf,S.N., 2003. "Multinomial choice with social interactions," Working papers 1, Wisconsin Madison - Social Systems.
  5. William A. Brock & Steven N. Durlauf, 2000. "Interactions-Based Models," Working Papers 00-05-028, Santa Fe Institute.
  6. Revelli, Federico, 2006. "Performance rating and yardstick competition in social service provision," Journal of Public Economics, Elsevier, vol. 90(3), pages 459-475, February.
  7. Anna Aizer & Janet Currie, 2002. "Networks or Neighborhoods? Correlations in the Use of Publicly-Funded Maternity Care in California," NBER Working Papers 9209, National Bureau of Economic Research, Inc.
  8. 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.
  9. Patrick S. Romano & Ryan Mutter, 2004. "The Evolving Science of Quality Measurement for Hospitals: Implications for Studies of Competition and Consolidation," International Journal of Health Care Finance and Economics, Springer, vol. 4(2), pages 131-157, 06.
  10. Daniel Birke, 2009. "The Economics Of Networks: A Survey Of The Empirical Literature," Journal of Economic Surveys, Wiley Blackwell, vol. 23(4), pages 762-793, 09.
  11. Dana Goldman & John A. Romley, 2008. "Hospitals As Hotels: The Role of Patient Amenities in Hospital Demand," NBER Working Papers 14619, National Bureau of Economic Research, Inc.
  12. Jonathan Skinner & Douglas Staiger, 2005. "Technology Adoption From Hybrid Corn to Beta Blockers," NBER Working Papers 11251, National Bureau of Economic Research, Inc.
  13. Deri, Catherine, 2005. "Social networks and health service utilization," Journal of Health Economics, Elsevier, vol. 24(6), pages 1076-1107, November.
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