Driving time drives the hospital choice: choice models for pelvic organ prolapse surgery in Italy

Amerigo Ferrari (), Chiara Seghieri, Andrea Giannini, Paolo Mannella, Tommaso Simoncini and Milena Vainieri
Additional contact information
Amerigo Ferrari: Sant’Anna School of Advanced Studies
Chiara Seghieri: Sant’Anna School of Advanced Studies
Andrea Giannini: University of Pisa
Paolo Mannella: University of Pisa
Tommaso Simoncini: University of Pisa
Milena Vainieri: Sant’Anna School of Advanced Studies

The European Journal of Health Economics, 2023, vol. 24, issue 9, No 12, 1575-1586

Abstract: Abstract Objective The Italian healthcare jurisdiction promotes patient mobility, which is a major determinant of practice variation, thus being related to the equity of access to health services. We aimed to explore how travel times, waiting times, and other efficiency- and quality-related hospital attributes influenced the hospital choice of women needing pelvic organ prolapse (POP) surgery in Tuscany, Italy. Methods We obtained the study population from Hospital Discharge Records. We duplicated individual observations (n = 2533) for the number of Tuscan hospitals that provided more than 30 POP interventions from 2017 to 2019 (n = 22) and merged them with the hospitals’ list. We generated the dichotomous variable “hospital choice” assuming the value one when hospitals where patients underwent surgery coincided with one of the 22 hospitals. We performed mixed logit models to explore between-hospital patient choice, gradually adding the women’s features as interactions. Results Patient choice was influenced by travel more than waiting times. A general preference for hospitals delivering higher volumes of interventions emerged. Interaction analyses showed that poorly educated women were less likely to choose distant hospitals and hospitals providing greater volumes of interventions compared to their counterpart. Women with multiple comorbidities more frequently chose hospitals with shorter average length of stay. Conclusion Travel times were the main determinants of hospital choice. Other quality- and efficiency-related hospital attributes influenced hospital choice as well. However, the effect depended on the socioeconomic and clinical background of women. Managers and policymakers should consider these findings to understand how women behave in choosing providers and thus mitigate equity gaps.

Keywords: Pelvic organ prolapse; Gynecological surgery; Hospital choice; Patient mobility; Discrete choice analysis; Mixed logit model (search for similar items in EconPapers)
JEL-codes: I12 (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s10198-022-01563-6 Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
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:spr:eujhec:v:24:y:2023:i:9:d:10.1007_s10198-022-01563-6

Ordering information: This journal article can be ordered from
http://www.springer. ... cs/journal/10198/PS2

DOI: 10.1007/s10198-022-01563-6

Access Statistics for this article

The European Journal of Health Economics is currently edited by J.-M.G.v.d. Schulenburg

More articles in The European Journal of Health Economics from Springer, Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ) Contact information at EDIRC.
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().