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The geography of hospital admission in a National Health Service with patient choice: Evidence from Italy

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  • Fabbri D
  • Robone S

Abstract

Every year 35% of the 10 million hospital admissions in Italy occurs outside the patients' Local Health Authority of residence. In this paper we look for explanation for this phenomenon and estimate gravity equations for "trade" in hospital care using a Poisson pseudo maximum likelihood method. Our results suggest that the gravity model is a good framework for explaining patient mobility in most of the examined diagnostic groups. We find that the ability to restrain the imports of hospital services increases with the size of the pool of enrollees. Moreover, the ability to export hospital services, as proxied by the ratio of export-to-internal demand, is U-shaped. Therefore our evidence suggests that there are scale effects played by the size of the pool of enrollees.

Suggested Citation

  • Fabbri D & Robone S, 2009. "The geography of hospital admission in a National Health Service with patient choice: Evidence from Italy," Health, Econometrics and Data Group (HEDG) Working Papers 09/10, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:09/10
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    References listed on IDEAS

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    Cited by:

    1. Claudio Pinto, 2017. "Perceived quality and formation of inter-regional networks of health care migration," Advances in Management and Applied Economics, SCIENPRESS Ltd, vol. 7(3), pages 1-5.
    2. repec:cep:sticas:/174 is not listed on IDEAS
    3. Tania Burchardt & Martin Evans & Holly Holder, 2013. "Public policy and inequalities of choice and autonomy," CASE Papers case174, Centre for Analysis of Social Exclusion, LSE.

    More about this item

    Keywords

    patients mobility; hospital care; gravity model; Italian National Health Service;

    JEL classification:

    • C72 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Noncooperative Games
    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • L14 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Transactional Relationships; Contracts and Reputation

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