Please use this identifier to cite or link to this item: http://hdl.handle.net/10419/159865
Authors: 
Lippi Bruni, Matteo
Mammi, Irene
Year of Publication: 
2015
Series/Report no.: 
Quaderni - Working Paper DSE 1027
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.
JEL: 
I11
R12
C23
Persistent Identifier of the first edition: 
Creative Commons License: 
https://creativecommons.org/licenses/by-nc/3.0/
Document Type: 
Working Paper

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