Should I wait or should I go? Travelling versus waiting for better healthcare

Lippi Bruni, Matteo ; Ugolini, Cristina ; Verzulli, Rossella (2021) Should I wait or should I go? Travelling versus waiting for better healthcare. Bologna: Dipartimento di Scienze economiche, p. 47. DOI 10.6092/unibo/amsacta/6705. In: Quaderni - Working Paper DSE (1162). ISSN 2282-6483.
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We study patient mobility in the Italian National Health System, using patient-episode level data on elective Percutaneous Transluminal Coronary Angioplasty procedures over the years 2008-2011. We examine how patients’ choice of the hospital is affected by changes in waiting times and clinical quality within hospitals over time. We estimate mixed-logit specifications and show the importance of jointly controlling for time-invariant and time varying clinical quality to identify the effect of waiting times. Conversely, failure to capture variations in clinical quality over time does not affect the estimate of the discouraging effect of travel distance. We provide evidence that patients are responsive to changes in waiting times and clinical quality: average demand elasticity with respect to own waiting times and mortality is estimated to be – 0.17 and – 1.38, respectively. Patients’ personal characteristics significantly influence how they trade off distance and waiting times with quality of care. We find a higher Willigness-To-Wait and Willingness-to-Travel to seek higher quality care for patients in the younger age groups and who are more severely ill. The results convey important policy implications for highly regulated healthcare markets.

Document type
Monograph (Working Paper)
Lippi Bruni, MatteoUniversity of Bologna0000-0002-1575-0352
Ugolini, CristinaUniversity of Bologna0000-0001-8453-674X
Verzulli, RossellaUniversity of Bologna0000-0001-5944-4421
patients’ mobility, hospital choice, travel distance, waiting times, healthcare quality, mixed logit models.
Deposit date
03 Jun 2021 08:37
Last modified
03 Jun 2021 08:37

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