Seminar co-organized with CERGAS
“Patient choice and hospital quality: Is there a neighborhood effect?”
SPEAKER: Anna-Theresa Renner (Vienna University of Technology)
The success of increasing hospital competition through free provider choice depends on patients' sensitivity towards quality, which depends on the availability of information regarding quality. We investigate how hospital choice for elective hip replacement surgery is influenced by adverse events experienced by patients from the same neighbourhood, compared to the quality of a hospital as experienced by all observed patients. We exploit a dataset of all elderly Italian patients who underwent elective hip replacement surgery from 2010 to 2015. Using a patient-level random utility choice model we find that -- independent of the overall quality of a hospital -- patients are more likely to choose hospitals with a low rate of “local” adverse events, proxied by in-hospital mortality and readmission rates of patients from the same neighbourhood. This result holds for rural and urban municipalities, and is robust to a set sensitivity checks. Our findings suggest that, in the absence of official statistics, patients do not select hospitals with the highest treatment quality, but rather avoid those where their neighbours experienced adverse events.
Anna-Theresa Renner holds the tenure track position of “Social Infrastructure Research and Planning” at the Research Unit of Public Finance and Infrastructure Policy at the Institute of Spatial Planning. Her main focus lies on regional and geographic variations of in- and outpatient healthcare supply, and the effects of unequal spatial distribution of healthcare services on patient health and mobility. She is currently also working on the impact of extreme heat events on hospitalizations and working accidents in Austria, and on the effects of in-utero exposure to disease outbreaks on early child outcomes in India. Anna-Theresa was a visiting scholar at the Weatherhead Center for International Affairs at Harvard University in 2021/22 funded by the “Austrian Marshall Plan Foundation-Schumpeter Fellowship”. Her previous affiliations include the Vienna University of Economics and Business, the Vienna Institute of Demography/Austrian Academy of Science, and the Austrian Public Health Institute (Gesundheit Österreich GmbH).
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