Do Market Incentives in the Hospital Industry Affect Subjective Health Perceptions? Evidence from the Italian PPS-DRG Reform

Lorenzo Cappellari, Anna De Paoli and Gilberto Turati ()

No 8636, IZA Discussion Papers from Institute of Labor Economics (IZA)

Abstract: We exploit time variation across Italian Regions in the implementation of a prospective pay systems (PPS) for hospitals based on Diagnosis Related Groups (DRGs) to assess their impact on self-assessed health status and on the use of health care services. We consider a survey of more than 600,000 individuals, over the years 1993-2007, with information on both individuals' perceived health and their access to a number of health services. Results suggest that the introduction of market incentives via a fixed-price payment system does not lead to worst health perceptions. Instead, the reform marked a moderate decrease in hospitalization and day hospital treatments, coupled with a clear decrease in the access to emergency services. Results are robust to a number of sensitivity checks.

Keywords: health reforms; self-assessed health (search for similar items in EconPapers)
JEL-codes: I11 I18 (search for similar items in EconPapers)
Pages: 36 pages
Date: 2014-11
New Economics Papers: this item is included in nep-eur, nep-hea and nep-ltv
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Citations: View citations in EconPapers (2)

Published - revised version published as 'Do market incentives for hospitals affect health and service utilization? Evidence from prospective pya system-diagnosis-related groups tariffs in Italian regions' in: Journal of the Royal Statistical Society - Series A, 2016, 179 (4), 885-905

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