Spatial effects in hospital expenditures: a district level analysis

Lippi Bruni, Matteo ; Mammi, Irene (2015) Spatial effects in hospital expenditures: a district level analysis. Bologna: Dipartimento di Scienze economiche DSE, p. 25. DOI 10.6092/unibo/amsacta/4344. In: Quaderni - Working Paper DSE (1027). ISSN 2282-6483.
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Abstract

Geographical clusters in health expenditures are well documented and accounting for spatial interactions may contribute to properly identify the factors affecting the use of health services the most. As for hospital care, spillovers may derive from strategic behaviour of hospitals and from patients’ preferences that may induce mobility across jurisdictions, as well as from geographically-concentrated risk factors, knowledge transfer and interactions between different layers of care. Our paper focuses on a largely overlooked potential source of spillovers in hospital expenditure: the heterogeneity of primary care providers’ behaviour. To do so, we analyse expenditures associated to avoidable hospitalisations separately from expenditures for highly complex treatments, as the former are most likely affected by General Practitioners, while the latter are not. We use administrative data for Italy’s Region Emilia Romagna between 2007 and 2010. Since neighbouring districts may belong to different Local Health Authorities (LHAs), we employ a spatial contiguity matrix that allows to investigate the effects of geographical and institutional proximity and use it to estimate Spatial Autoregressive and Spatial Durbin Models.

Abstract
Document type
Monograph (Working Paper)
Creators
CreatorsAffiliationORCID
Lippi Bruni, Matteo
Mammi, Irene
Keywords
Hospital expenditures, spatial effects, panel data, institutionally-clustered data
Subjects
ISSN
2282-6483
DOI
Deposit date
08 Sep 2015 08:42
Last modified
23 Oct 2015 09:16
URI

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