The Life Saving Effects of Hospital Proximity

Paola Bertoli and Veronica Grembi

No 349, CEIS Research Paper from Tor Vergata University, CEIS

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.

Keywords: Access to care; Hospital Proximity; Road-Traffic Accidents; Instrumental Variables; Difference in Differences (search for similar items in EconPapers)
JEL-codes: C26 I10 R41 (search for similar items in EconPapers)
Pages: 43 pages
Date: 2015-07-01, Revised 2015-07-01
New Economics Papers: this item is included in nep-eur, nep-hea, nep-tre and nep-ure
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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Related works:
Journal Article: The life‐saving effect of hospital proximity (2017)
Working Paper: The Life-saving Effect of Hospital Proximity (2016)
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