A Matter of Life and Death? Hospital Distance and Quality of Care - Evidence from Emergency Hospital Closures and Myocardial Infarctions

Daniel Avdic ()

No 1501, CINCH Working Paper Series from Universitaet Duisburg-Essen, Competent in Competition and Health

Abstract: The article analyzes to which extent residential proximity from an emergency hospital affects the probability of surviving an acute myocardial infarction (AMI). The critical time aspect in AMI treatment provides an ideal application for evaluating this proximity outcome hypothesis. Previous studies have encountered empirical difficulties relating to potential endogenous health-based spatial sorting of involved agents and data limitations on out-of-hospital mortality. Using policyinduced variation in hospital distance arising from plausibly exogenous emergency hospital closures in the highly regulated Swedish health care sector, and data on all AMI deaths in Sweden over two decades, estimation results show a clear, robust and gradually declining probability of surviving an AMI of about two percentage points (three percent) per additional ten kilometers distance from a hospital. Results further show that spatial sorting and sample selection from outof-hospital mortality are likely to significantly attenuate the distance effect unless accounted for.

Keywords: myocardial infarction; geographical access; hospital closures; health policy; spatial sorting; self-selection; out-of-hospital mortality; causal effect (search for similar items in EconPapers)
JEL-codes: C23 I14 I18 R41 (search for similar items in EconPapers)
Pages: 61 pages
Date: 2015-01, Revised 2015-01
New Economics Papers: this item is included in nep-eur, nep-hea and nep-ure
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (12)

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Working Paper: A matter of life and death? Hospital distance and quality of care: evidence from emergency hospital closures and myocardial infarctions (2015)
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