Spatial disparities in hospital performance

Laurent Gobillon and Carine Milcent

Post-Print from HAL

Abstract: Using a French exhaustive dataset, this article studies the determinants of regional disparities in mortality for patients admitted to hospitals for a heart attack. These disparities are large, with an 80% difference in the propensity to die within 15 days between extreme regions. They may reflect spatial differences in patient characteristics, treatments, hospital characteristics and local healthcare market structure. To distinguish between these factors, we estimate a flexible duration model. The estimated model is aggregated at the regional level and a spatial variance analysis is conducted. We find that spatial differences in the use of innovative treatments play a major role whereas the local composition of hospitals by ownership does not have any noticeable effect. Moreover, the higher the local concentration of patients in a few large hospitals rather than many small ones, the lower the mortality. Regional unobserved effects account for around 20% of spatial disparities.

Keywords: Spatial health disparities; Economic geography; Stratified duration model (search for similar items in EconPapers)
Date: 2013-09
New Economics Papers: this item is included in nep-eur, nep-geo, nep-ger, nep-hea and nep-ure
Note: View the original document on HAL open archive server: https://shs.hal.science/halshs-00879787v1
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (11)

Published in Journal of Economic Geography, 2013, 13 (6), pp.1013-1040. ⟨10.1093/jeg/lbs065⟩

Downloads: (external link)
https://shs.hal.science/halshs-00879787v1/document (application/pdf)

Related works:
Journal Article: Spatial disparities in hospital performance (2013)
Working Paper: Spatial disparities in hospital performance (2013)
Working Paper: Spatial Disparities in Hospital Performance (2012)
Working Paper: Spatial disparities in hospital performances (2010)
Working Paper: Spatial Disparities in Hospital Performances (2010)
Working Paper: Spatial Disparities in Hospital Performances (2010)
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:halshs-00879787

DOI: 10.1093/jeg/lbs065

Access Statistics for this paper

More papers in Post-Print from HAL
Bibliographic data for series maintained by CCSD ().