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The Life Saving Effects of Hospital Proximity

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Abstract

We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from the exogenous variation in the proximity to cities that are allowed by law to have a hospital based on their population size. Our instrumental variable results, based on Italian municipalities data from 2000 to 2012, show that an increase by a standard deviation of distance to the nearest hospital (5 km) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters more when the road safety is low; the emergency service is not properly organized, and the nearest hospital has lower quality standards.

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  • Paola Bertoli & Veronica Grembi, 2015. "The Life Saving Effects of Hospital Proximity," CEIS Research Paper 349, Tor Vergata University, CEIS, revised 01 Jul 2015.
  • Handle: RePEc:rtv:ceisrp:349
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    Cited by:

    1. 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.
    2. 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.
    3. repec:eee:pubeco:v:174:y:2019:i:c:p:22-35 is not listed on IDEAS
    4. Sofia Amaral-Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities in Italy," CERGE-EI Working Papers wp540, The Center for Economic Research and Graduate Education - Economics Institute, Prague.

    More about this item

    Keywords

    Access to care; Hospital Proximity; Road-Traffic Accidents; Instrumental Variables; Difference in Differences;

    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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