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

Daniele Fabbri and Silvana Robone

Health, Econometrics and Data Group (HEDG) Working Papers from HEDG, c/o Department of Economics, University of York

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.

Keywords: patients mobility; hospital care; gravity model; Italian National Health Service (search for similar items in EconPapers)
Date: 2009-06
New Economics Papers: this item is included in nep-hea and nep-ure
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Working Paper: The geography of hospital admission in a National Health Service with patient choice: Evidence from Italy (2009)
Working Paper: The geography of hospital admission in a National Health Service with patient choice: evidence from Italy (2008)
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