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Hospitals' Strategic Behaviours and Patient Mobility: Evidence from Italy

Paolo Berta (), Carla Guerriero () and Rosella Levaggi
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Paolo Berta: Università di Milano-Bicocca
Carla Guerriero: Università di Napoli Federico II and CSEF

CSEF Working Papers from Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy

Abstract: The aim of this study is to explore hospitals' behaviours in attracting extra-regional patients and to investigate the effects of these behaviours on the quality of care to resident patients in a context where choices by regional patients are constrained by a budget cap and extra-regional patients are unconstrained source of revenue. Empirical results suggest that, controlling for hospital fixed effects, patients' demographic and health characteristics, hospitals use waiting times and length of stay to attract exra-regional patients. Regional patients admitted in both private and public hospitals with higher proportions of extra-regional patients show lower mortality rates and reimbursement costs. These results suggest that competition increases the quality of care and reduces costs through spillover effects produced by the market for extra-regional patients. Finally, the pattern of reimbursement asked for extra-regional care generates a financial flow in favour of richer regions, exacerbating the north-south gradient in the Italian NHS.

Keywords: Hospital competition; patient mobility; mixed market; quality of care. (search for similar items in EconPapers)
JEL-codes: H51 H77 D6 C70 (search for similar items in EconPapers)
Date: 2020-01-23
New Economics Papers: this item is included in nep-eur, nep-hea and nep-ure
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