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Social interactions in inappropriate behavior for childbirth services: Theory and evidence from the Italian hospital sector

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  • Guccio, C.
  • Lisi, D.

Abstract

Over the last decades the role of social interactions has become increasingly important in the economic discussion and, by now, it is acknowledged that the interaction across agents can produce both positive and negative effects. In this paper we evaluate the role of social interactions in the hospital sector using the large incidence of caesarean section, usually considered an inappropriate outcome in the childbirth service. In doing so, we lay out a theoretical model of hospitals’ behavior where the effect of peers’ behavior emerges by the simple sharing of the same institutional authority. Then, using the risk adjusted cesarean section rate of a large panel of Italian hospitals, we empirically investigate whether the behavior of each hospital is affected by the behavior of hospitals within the same region, after controlling for demand, supply and financial factors. In particular, we perform our empirical test employing both peer effects estimate and the spatial econometric approach, exploiting the panel dimension of our data. Both estimates show a significant and strong presence of peer effects among hospitals, robust to sensitivity analyses. We interpret this evidence as a large presence of constraint interactions in the healthcare sector, with important implications for the healthcare policy.

Suggested Citation

  • Guccio, C. & Lisi, D., 2014. "Social interactions in inappropriate behavior for childbirth services: Theory and evidence from the Italian hospital sector," Health, Econometrics and Data Group (HEDG) Working Papers 14/28, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:14/28
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    1. Marina Cavalieri & Calogero Guccio & Domenico Lisi & Giacomo Pignataro, 2014. "Financial Incentives and Inappropriateness in Health Care: Evidence from Italian Cesarean Sections," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 70(3), pages 430-457, September.
    2. Bénédicte Apouey & Gabriel Picone, 2014. "Social Interactions And Malaria Preventive Behaviors In Sub‐Saharan Africa," Health Economics, John Wiley & Sons, Ltd., vol. 23(9), pages 994-1012, September.
    3. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
    4. Chandra, Amitabh & Cutler, David & Song, Zirui, 2011. "Who Ordered That? The Economics of Treatment Choices in Medical Care," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 397-432, Elsevier.
    5. Trogdon, Justin G. & Nonnemaker, James & Pais, Joanne, 2008. "Peer effects in adolescent overweight," Journal of Health Economics, Elsevier, vol. 27(5), pages 1388-1399, September.
    6. Charles F. Manski, 2000. "Economic Analysis of Social Interactions," Journal of Economic Perspectives, American Economic Association, vol. 14(3), pages 115-136, Summer.
    7. Brock, William A. & Durlauf, Steven N., 2007. "Identification of binary choice models with social interactions," Journal of Econometrics, Elsevier, vol. 140(1), pages 52-75, September.
    8. Arbia, Giuseppe & Battisti, Michele & Di Vaio, Gianfranco, 2010. "Institutions and geography: Empirical test of spatial growth models for European regions," Economic Modelling, Elsevier, vol. 27(1), pages 12-21, January.
    9. Kabakian-Khasholian, Tamar & Kaddour, Afamia & DeJong, Jocelyn & Shayboub, Rawan & Nassar, Anwar, 2007. "The policy environment encouraging C-section in Lebanon," Health Policy, Elsevier, vol. 83(1), pages 37-49, September.
    10. Dani Rodrik & Arvind Subramanian & Francesco Trebbi, 2004. "Institutions Rule: The Primacy of Institutions Over Geography and Integration in Economic Development," Journal of Economic Growth, Springer, vol. 9(2), pages 131-165, June.
    11. Lee, Kwangsoo & Lee, Sangil, 2007. "Effects of the DRG-based prospective payment system operated by the voluntarily participating providers on the cesarean section rates in Korea," Health Policy, Elsevier, vol. 81(2-3), pages 300-308, May.
    12. David J. Zimmerman, 2003. "Peer Effects in Academic Outcomes: Evidence from a Natural Experiment," The Review of Economics and Statistics, MIT Press, vol. 85(1), pages 9-23, February.
    13. Grant, Darren, 2009. "Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project," Journal of Health Economics, Elsevier, vol. 28(1), pages 244-250, January.
    14. Galbiati, Roberto & Zanella, Giulio, 2012. "The tax evasion social multiplier: Evidence from Italy," Journal of Public Economics, Elsevier, vol. 96(5), pages 485-494.
    15. Atella, Vincenzo & Belotti, Federico & Depalo, Domenico & Piano Mortari, Andrea, 2014. "Measuring spatial effects in the presence of institutional constraints: The case of Italian Local Health Authority expenditure," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 232-241.
    16. Charles F. Manski, 1993. "Identification of Endogenous Social Effects: The Reflection Problem," Review of Economic Studies, Oxford University Press, vol. 60(3), pages 531-542.
    17. Epstein, Andrew J. & Nicholson, Sean, 2009. "The formation and evolution of physician treatment styles: An application to cesarean sections," Journal of Health Economics, Elsevier, vol. 28(6), pages 1126-1140, December.
    18. Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), 2011. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, volume 2, number 2, 00.
    19. Sah, Raaj K, 1991. "Social Osmosis and Patterns of Crime," Journal of Political Economy, University of Chicago Press, vol. 99(6), pages 1272-1295, December.
    20. Kevin M. Murphy & Robert H. Topel, 2006. "The Value of Health and Longevity," Journal of Political Economy, University of Chicago Press, vol. 114(5), pages 871-904, October.
    21. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    22. Epple, Dennis & Romano, Richard E, 1998. "Competition between Private and Public Schools, Vouchers, and Peer-Group Effects," American Economic Review, American Economic Association, vol. 88(1), pages 33-62, March.
    23. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, vol. 18(4), pages 491-522, August.
    24. Hausman, Jerry A & Leonard, Gregory K, 1997. "Superstars in the National Basketball Association: Economic Value and Policy," Journal of Labor Economics, University of Chicago Press, vol. 15(4), pages 586-624, October.
    25. Auld, M. Christopher, 2011. "Effect of large-scale social interactions on body weight," Journal of Health Economics, Elsevier, vol. 30(2), pages 303-316, March.
    26. Edward L. Glaeser & Bruce Sacerdote & José A. Scheinkman, 1996. "Crime and Social Interactions," The Quarterly Journal of Economics, Oxford University Press, vol. 111(2), pages 507-548.
    27. Timothy G. Conley & Giorgio Topa, 2003. "Identification of local interaction models with imperfect location data," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 18(5), pages 605-618.
    28. Papke, Leslie E. & Wooldridge, Jeffrey M., 2008. "Panel data methods for fractional response variables with an application to test pass rates," Journal of Econometrics, Elsevier, vol. 145(1-2), pages 121-133, July.
    29. Abdul-Rahim, Hanan F. & Abu-Rmeileh, Niveen Mohammad Elias & Wick, Laura, 2009. "Cesarean section deliveries in the occupied Palestinian territory (oPt): An analysis of the 2006 Palestinian Family Health Survey," Health Policy, Elsevier, vol. 93(2-3), pages 151-156, December.
    30. Lo, Joan C., 2003. "Patients' attitudes vs. physicians' determination: implications for cesarean sections," Social Science & Medicine, Elsevier, vol. 57(1), pages 91-96, July.
    31. F. Moscone & E. Tosetti & G. Vittadini, 2012. "Social interaction in patients’ hospital choice: evidence from Italy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 453-472, April.
    32. Hopkins, Kristine, 2000. "Are Brazilian women really choosing to deliver by cesarean?," Social Science & Medicine, Elsevier, vol. 51(5), pages 725-740, September.
    33. Francese, Maura & Piacenza, Massimiliano & Romanelli, Marzia & Turati, Gilberto, 2014. "Understanding inappropriateness in health spending: The role of regional policies and institutions in caesarean deliveries," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 262-277.
    34. Hugh Gravelle & Rita Santos & Luigi Siciliani, 2013. "Does a hospitals quality depend on the quality of other hospitals? A spatial econometrics approach to investigating hospital quality competition," Working Papers 082cherp, Centre for Health Economics, University of York.
    35. Bruce Sacerdote, 2001. "Peer Effects with Random Assignment: Results for Dartmouth Roommates," The Quarterly Journal of Economics, Oxford University Press, vol. 116(2), pages 681-704.
    36. Hsu, Kuang-Hung & Liao, Pei-Ju & Hwang, Chorng-Jer, 2008. "Factors affecting Taiwanese women's choice of cesarean section," Social Science & Medicine, Elsevier, vol. 66(1), pages 201-209, January.
    37. Skinner, Jonathan, 2011. "Causes and Consequences of Regional Variations in Health Care," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 45-93, Elsevier.
    38. Papke, Leslie E & Wooldridge, Jeffrey M, 1996. "Econometric Methods for Fractional Response Variables with an Application to 401(K) Plan Participation Rates," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 11(6), pages 619-632, Nov.-Dec..
    39. Nigam, Amit, 2012. "The effects of institutional change on geographic variation and health services use in the USA," Social Science & Medicine, Elsevier, vol. 74(3), pages 323-331.
    40. Darren Grant, 2005. "Information and sorting in the market for obstetrical services," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 703-719, July.
    41. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
    42. Defever, Mia, 1985. "Health system support for primary health care : B. Klezkowski et al. Public Health Papers, 80 World Health Organization, Geneva, 1984, 104 p," Health Policy, Elsevier, vol. 5(1), pages 84-81.
    43. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
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    Cited by:

    1. Guccio, Calogero & Lisi, Domenico, 2016. "Thus do all. Social interactions in inappropriate behavior for childbirth services in a highly decentralized healthcare system," Regional Science and Urban Economics, Elsevier, vol. 61(C), pages 1-17.

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    More about this item

    Keywords

    social interactions; peer effects; caesarian section; spatial econometrics;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models

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