Spatial effects in hospital expenditures: a district level analysis

Arbeitspapier

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.

Object Details

• Language: Englisch

References and Relationships

• Bibliographic citation: Series: Quaderni - Working Paper DSE ; No. 1027

Classification and Topics

• Classification: Wirtschaft ; Analysis of Health Care Markets ; Size and Spatial Distributions of Regional Economic Activity ; Single Equation Models; Single Variables: Panel Data Models; Spatio-temporal Models

Contributors, Places and Time

• Event: Geistige Schöpfung
• (who): Lippi Bruni, Matteo ; Mammi, Irene
• Event: Veröffentlichung
• (who): Alma Mater Studiorum - Università di Bologna, Dipartimento di Scienze Economiche (DSE)
• (where): Bologna
• (when): 2015

Further information

• DOI: doi:10.6092/unibo/amsacta/4344
• Handle: http://hdl.handle.net/10419/159865
• Last update: 10.03.2025, 11:44 AM CET