Spatial effects in hospital expenditures: a district level analysis

Matteo Lippi Bruni () and Irene Mammi

Working Papers from Dipartimento Scienze Economiche, Universita' di Bologna

Abstract: Geographical clusters in health expenditures are well documented and accounting for spatial interactions may contribute to properly identify the factors affecting the use of health services the most. As for hospital care, spillovers may derive from strategic behaviour of hospitals and from patients preferences that may induce mobility across jurisdictions, as well as from geographically-concentrated risk factors, knowledge transfer and interactions between different layers of care. Our paper focuses on a largely overlooked potential source of spillovers in hospital expenditure: the heterogeneity of primary care providers behaviour. To do so, we analyse expenditures associated to avoidable hospitalisations separately from expenditures for highly complex treatments, as the former are most likely affected by General Practitioners, while the latter are not. We use administrative data for Italy s Region Emilia Romagna between 2007 and 2010. Since neighbouring districts may belong to different Local Health Authorities (LHAs), we employ a spatial contiguity matrix that allows to investigate the effects of geographical and institutional proximity and use it to estimate Spatial Autoregressive and Spatial Durbin Models.

JEL-codes: C23 I11 R12 (search for similar items in EconPapers)
Date: 2015-09
New Economics Papers: this item is included in nep-eur, nep-geo, nep-hea and nep-ure
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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Journal Article: Spatial effects in hospital expenditures: A district level analysis (2017)
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Persistent link: https://EconPapers.repec.org/RePEc:bol:bodewp:wp1027

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