IDEAS home Printed from https://ideas.repec.org/a/eee/regeco/v61y2016icp1-17.html
   My bibliography  Save this article

Thus do all. Social interactions in inappropriate behavior for childbirth services in a highly decentralized healthcare system

Author

Listed:
  • Guccio, Calogero
  • Lisi, Domenico

Abstract

Empirical evidence supports the conjecture that social interactions among agents can produce both positive and negative effects. We build on this literature by exploring the role of social interactions in the hospital sector using the large incidence of cesarean sections, usually considered an inappropriate outcome in the childbirth service. In doing so, we lay out a simple model of hospitals’ behavior where the effect of peers’ behavior emerges simply by sharing the same regional health authority responsible for auditing inappropriate behavior. In this setting, enforcement congestion induces a peer effect among hospitals that could make inappropriate behaviors more likely and, as a result, could increase the excess variance among regions. Then, using a unique dataset of Italian hospitals and 2007–2012 cesarean data, we empirically investigate whether the behavior of each hospital is affected by the behavior of hospitals within the same region. Our empirical findings show a significant and strong presence of peer effects among hospitals.

Suggested Citation

  • Guccio, Calogero & Lisi, Domenico, 2016. "Thus do all. Social interactions in inappropriate behavior for childbirth services in a highly decentralized healthcare system," Regional Science and Urban Economics, Elsevier, vol. 61(C), pages 1-17.
    • Handle: RePEc:eee:regeco:v:61:y:2016:i:c:p:1-17
    DOI: 10.1016/j.regsciurbeco.2016.08.004
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0166046216301557
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.regsciurbeco.2016.08.004?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Auld, M. Christopher, 2011. "Effect of large-scale social interactions on body weight," Journal of Health Economics, Elsevier, vol. 30(2), pages 303-316, March.
    2. Edward L. Glaeser & Bruce Sacerdote & José A. Scheinkman, 1996. "Crime and Social Interactions," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 507-548.
    3. Galbiati, Roberto & Zanella, Giulio, 2012. "The tax evasion social multiplier: Evidence from Italy," Journal of Public Economics, Elsevier, vol. 96(5), pages 485-494.
    4. Dani Rodrik & Arvind Subramanian & Francesco Trebbi, 2004. "Institutions Rule: The Primacy of Institutions Over Geography and Integration in Economic Development," Journal of Economic Growth, Springer, vol. 9(2), pages 131-165, June.
    5. Marina Cavalieri & Calogero Guccio & Domenico Lisi & Giacomo Pignataro, 2014. "Financial Incentives and Inappropriateness in Health Care: Evidence from Italian Cesarean Sections," FinanzArchiv: Public Finance Analysis, Mohr Siebeck, Tübingen, vol. 70(3), pages 430-457, September.
    6. repec:hal:pseose:halshs-01109038 is not listed on IDEAS
    7. Daniele Fabbri & Chiara Monfardini, 2008. "Style of practice and assortative mating: a recursive probit analysis of Caesarean section scheduling in Italy," Applied Economics, Taylor & Francis Journals, vol. 40(11), pages 1411-1423.
    8. Sah, Raaj K, 1991. "Social Osmosis and Patterns of Crime," Journal of Political Economy, University of Chicago Press, vol. 99(6), pages 1272-1295, December.
    9. Timothy G. Conley & Giorgio Topa, 2003. "Identification of local interaction models with imperfect location data," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 18(5), pages 605-618.
    10. Gravelle, Hugh & Santos, Rita & Siciliani, Luigi, 2014. "Does a hospital's quality depend on the quality of other hospitals? A spatial econometrics approach," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 203-216.
    11. Papke, Leslie E. & Wooldridge, Jeffrey M., 2008. "Panel data methods for fractional response variables with an application to test pass rates," Journal of Econometrics, Elsevier, vol. 145(1-2), pages 121-133, July.
    12. Bénédicte Apouey & Gabriel Picone, 2014. "Social Interactions And Malaria Preventive Behaviors In Sub‐Saharan Africa," Health Economics, John Wiley & Sons, Ltd., vol. 23(9), pages 994-1012, September.
    13. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
    14. Arbia, Giuseppe & Battisti, Michele & Di Vaio, Gianfranco, 2010. "Institutions and geography: Empirical test of spatial growth models for European regions," Economic Modelling, Elsevier, vol. 27(1), pages 12-21, January.
    15. Abdul-Rahim, Hanan F. & Abu-Rmeileh, Niveen Mohammad Elias & Wick, Laura, 2009. "Cesarean section deliveries in the occupied Palestinian territory (oPt): An analysis of the 2006 Palestinian Family Health Survey," Health Policy, Elsevier, vol. 93(2-3), pages 151-156, December.
    16. Chandra, Amitabh & Cutler, David & Song, Zirui, 2011. "Who Ordered That? The Economics of Treatment Choices in Medical Care," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 397-432, Elsevier.
    17. Trogdon, Justin G. & Nonnemaker, James & Pais, Joanne, 2008. "Peer effects in adolescent overweight," Journal of Health Economics, Elsevier, vol. 27(5), pages 1388-1399, September.
    18. Lo, Joan C., 2003. "Patients' attitudes vs. physicians' determination: implications for cesarean sections," Social Science & Medicine, Elsevier, vol. 57(1), pages 91-96, July.
    19. Charles F. Manski, 2000. "Economic Analysis of Social Interactions," Journal of Economic Perspectives, American Economic Association, vol. 14(3), pages 115-136, Summer.
    20. Gary Solon & Marianne E. Page & Greg J. Duncan, 2000. "Correlations Between Neighboring Children In Their Subsequent Educational Attainment," The Review of Economics and Statistics, MIT Press, vol. 82(3), pages 383-392, August.
    21. Brock, William A. & Durlauf, Steven N., 2007. "Identification of binary choice models with social interactions," Journal of Econometrics, Elsevier, vol. 140(1), pages 52-75, September.
    22. F. Moscone & E. Tosetti & G. Vittadini, 2012. "Social interaction in patients’ hospital choice: evidence from Italy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 175(2), pages 453-472, April.
    23. Finocchiaro Castro, Massimo & Guccio, Calogero & Pignataro, Giacomo & Rizzo, Ilde, 2014. "The effects of reimbursement mechanisms on medical technology diffusion in the hospital sector in the Italian NHS," Health Policy, Elsevier, vol. 115(2), pages 215-229.
    24. Hopkins, Kristine, 2000. "Are Brazilian women really choosing to deliver by cesarean?," Social Science & Medicine, Elsevier, vol. 51(5), pages 725-740, September.
    25. Sofia Amaral-Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities in Italy," CERGE-EI Working Papers wp540, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    26. Francese, Maura & Piacenza, Massimiliano & Romanelli, Marzia & Turati, Gilberto, 2014. "Understanding inappropriateness in health spending: The role of regional policies and institutions in caesarean deliveries," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 262-277.
    27. repec:hal:spmain:info:hdl:2441/2jbidihgpo8bia7dbd5ipjlsi9 is not listed on IDEAS
    28. Jensen, Vibeke Myrup & Wüst, Miriam, 2015. "Can Caesarean section improve child and maternal health? The case of breech babies," Journal of Health Economics, Elsevier, vol. 39(C), pages 289-302.
    29. Kevin M. Murphy & Robert H. Topel, 2006. "The Value of Health and Longevity," Journal of Political Economy, University of Chicago Press, vol. 114(5), pages 871-904, October.
    30. Sofia Amaral‐Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1050-1064, September.
    31. David J. Zimmerman, 2003. "Peer Effects in Academic Outcomes: Evidence from a Natural Experiment," The Review of Economics and Statistics, MIT Press, vol. 85(1), pages 9-23, February.
    32. Carol Propper & Simon Burgess & Denise Gossage, 2008. "Competition and Quality: Evidence from the NHS Internal Market 1991–9," Economic Journal, Royal Economic Society, vol. 118(525), pages 138-170, January.
    33. Kabakian-Khasholian, Tamar & Kaddour, Afamia & DeJong, Jocelyn & Shayboub, Rawan & Nassar, Anwar, 2007. "The policy environment encouraging C-section in Lebanon," Health Policy, Elsevier, vol. 83(1), pages 37-49, September.
    34. Charles F. Manski, 1993. "Identification of Endogenous Social Effects: The Reflection Problem," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 60(3), pages 531-542.
    35. Guccio, C. & Lisi, D., 2014. "Social interactions in inappropriate behavior for childbirth services: Theory and evidence from the Italian hospital sector," Health, Econometrics and Data Group (HEDG) Working Papers 14/28, HEDG, c/o Department of Economics, University of York.
    36. Epstein, Andrew J. & Nicholson, Sean, 2009. "The formation and evolution of physician treatment styles: An application to cesarean sections," Journal of Health Economics, Elsevier, vol. 28(6), pages 1126-1140, December.
    37. Bruce Sacerdote, 2001. "Peer Effects with Random Assignment: Results for Dartmouth Roommates," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 116(2), pages 681-704.
    38. Hsu, Kuang-Hung & Liao, Pei-Ju & Hwang, Chorng-Jer, 2008. "Factors affecting Taiwanese women's choice of cesarean section," Social Science & Medicine, Elsevier, vol. 66(1), pages 201-209, January.
    39. George France & Francesco Taroni & Andrea Donatini, 2005. "The Italian health‐care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 187-202, September.
    40. Atella, Vincenzo & Belotti, Federico & Depalo, Domenico & Piano Mortari, Andrea, 2014. "Measuring spatial effects in the presence of institutional constraints: The case of Italian Local Health Authority expenditure," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 232-241.
    41. Skinner, Jonathan, 2011. "Causes and Consequences of Regional Variations in Health Care," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 45-93, Elsevier.
    42. Papke, Leslie E & Wooldridge, Jeffrey M, 1996. "Econometric Methods for Fractional Response Variables with an Application to 401(K) Plan Participation Rates," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 11(6), pages 619-632, Nov.-Dec..
    43. Grant, Darren, 2009. "Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project," Journal of Health Economics, Elsevier, vol. 28(1), pages 244-250, January.
    44. Darren Grant, 2005. "Information and sorting in the market for obstetrical services," Health Economics, John Wiley & Sons, Ltd., vol. 14(7), pages 703-719, July.
    45. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
    46. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    47. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
    48. Epple, Dennis & Romano, Richard E, 1998. "Competition between Private and Public Schools, Vouchers, and Peer-Group Effects," American Economic Review, American Economic Association, vol. 88(1), pages 33-62, March.
    49. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, vol. 18(4), pages 491-522, August.
    50. Hausman, Jerry A & Leonard, Gregory K, 1997. "Superstars in the National Basketball Association: Economic Value and Policy," Journal of Labor Economics, University of Chicago Press, vol. 15(4), pages 586-624, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    2. Paola Bertoli & Veronica Grembi, 2017. "The life‐saving effect of hospital proximity," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 78-91, September.
    3. Johann Han & Nadja Kairies-Schwarz & Markus Vomhof, 2024. "Strategic behaviour and decision making in competitive hospital markets: an experimental investigation," International Journal of Health Economics and Management, Springer, vol. 24(3), pages 333-355, September.
    4. Lisi, D.; Moscone, F.; Tosetti, E.; Vinciotti, V.;, 2017. "Hospital interdependence in a competitive institutional environment: Evidence from Italy," Health, Econometrics and Data Group (HEDG) Working Papers 17/07, HEDG, c/o Department of Economics, University of York.
    5. Guccio, C. & Lisi, D. & Martorana, M.F. & Pignataro, G., 2020. "Incorporating quality in the efficiency assessment of hospitals using a generalized directional distance function approach," Health, Econometrics and Data Group (HEDG) Working Papers 20/17, HEDG, c/o Department of Economics, University of York.
    6. De Luca, Giacomo & Lisi, Domenico & Martorana, Marco & Siciliani, Luigi, 2021. "Does higher Institutional Quality improve the Appropriateness of Healthcare Provision?," Journal of Public Economics, Elsevier, vol. 194(C).
    7. Han, Johann & Kairies-Schwarz, Nadja & Vomhof, Markus, 2020. "Quality provision in competitive health care markets: Individuals vs. teams," Ruhr Economic Papers 839, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    8. Lisi, Domenico & Moscone, Francesco & Tosetti, Elisa & Vinciotti, Veronica, 2021. "Hospital quality interdependence in a competitive institutional environment: Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 89(C).
    9. Roberto Cellini & Tiziana Cuccia & Domenico Lisi, 2020. "Spatial dependence in museum services: an analysis of the Italian case," Journal of Cultural Economics, Springer;The Association for Cultural Economics International, vol. 44(4), pages 535-562, December.
    10. Francesco Longo & Luigi Siciliani & Hugh Gravelle & Rita Santos, 2017. "Do hospitals respond to rivals' quality and efficiency? A spatial panel econometric analysis," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 38-62, September.
    11. Vidoli, Francesco & Auteri, Monica, 2022. "Health-care demand and supply at municipal level: A spatial disaggregation approach," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).
    12. Paola Bertoli & Veronica Grembi, 2017. "Exploring the Nexus between Certainty in Injury Compensation and Treatment Selection," CERGE-EI Working Papers wp603, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    13. Cavalieri, Marina & Di Caro, Paolo & Guccio, Calogero & Lisi, Domenico, 2020. "Does neighbours' grass matter? Testing spatial dependent heterogeneity in technical efficiency of Italian hospitals," Social Science & Medicine, Elsevier, vol. 265(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Guccio, C. & Lisi, D., 2014. "Social interactions in inappropriate behavior for childbirth services: Theory and evidence from the Italian hospital sector," Health, Econometrics and Data Group (HEDG) Working Papers 14/28, HEDG, c/o Department of Economics, University of York.
    2. De Luca, Giacomo & Lisi, Domenico & Martorana, Marco & Siciliani, Luigi, 2021. "Does higher Institutional Quality improve the Appropriateness of Healthcare Provision?," Journal of Public Economics, Elsevier, vol. 194(C).
    3. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    4. Francese, Maura & Piacenza, Massimiliano & Romanelli, Marzia & Turati, Gilberto, 2014. "Understanding inappropriateness in health spending: The role of regional policies and institutions in caesarean deliveries," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 262-277.
    5. Jose-Alberto Guerra & Myra Mohnen, 2022. "Multinomial Choice with Social Interactions: Occupations in Victorian London," The Review of Economics and Statistics, MIT Press, vol. 104(4), pages 736-747, October.
    6. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    7. Steven N. Durlauf & Yannis M. Ioannides, 2010. "Social Interactions," Annual Review of Economics, Annual Reviews, vol. 2(1), pages 451-478, September.
    8. Kang, Changhui, 2007. "Classroom peer effects and academic achievement: Quasi-randomization evidence from South Korea," Journal of Urban Economics, Elsevier, vol. 61(3), pages 458-495, May.
    9. Daniele Fabbri & Chiara Monfardini, 2008. "Style of practice and assortative mating: a recursive probit analysis of Caesarean section scheduling in Italy," Applied Economics, Taylor & Francis Journals, vol. 40(11), pages 1411-1423.
    10. Galbiati, Roberto & Zanella, Giulio, 2012. "The tax evasion social multiplier: Evidence from Italy," Journal of Public Economics, Elsevier, vol. 96(5), pages 485-494.
    11. Maura Francese & Massimiliano Piacenza & Marzia Romanelli & Gilberto Turati, 2011. "Understanding Inappropriateness in Health Care: The Role of Supply Structure, Pricing Policies and Political Institutions in Caesarean Deliveries," ERSA conference papers ersa11p1439, European Regional Science Association.
    12. Piero Cipollone & Alfonso Rosolia, 2007. "Social Interactions in High School: Lessons from an Earthquake," American Economic Review, American Economic Association, vol. 97(3), pages 948-965, June.
    13. Sofia Amaral-Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities in Italy," CEIS Research Paper 342, Tor Vergata University, CEIS, revised 08 May 2015.
    14. Bramoullé, Yann & Djebbari, Habiba & Fortin, Bernard, 2009. "Identification of peer effects through social networks," Journal of Econometrics, Elsevier, vol. 150(1), pages 41-55, May.
    15. Kling, Jeffrey & Liebman, Jeffrey, 2004. "Experimental Analysis of Neighborhood Effects on Youth," Working Paper Series rwp04-034, Harvard University, John F. Kennedy School of Government.
    16. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    17. Castro, M.F.; & Ferrara, P.; & Guccio, C.; & Lisi, D.;, 2018. "Medical Malpractice Liability and Physicians’ Behavior:Experimental Evidence," Health, Econometrics and Data Group (HEDG) Working Papers 18/11, HEDG, c/o Department of Economics, University of York.
    18. repec:spo:wpmain:info:hdl:2441/2jbidihgpo8bia7dbd5ipjlsi9 is not listed on IDEAS
    19. Castro, Massimo Finocchiaro & Ferrara, Paolo Lorenzo & Guccio, Calogero & Lisi, Domenico, 2019. "Medical malpractice liability and physicians’ behavior: Experimental evidence," Journal of Economic Behavior & Organization, Elsevier, vol. 166(C), pages 646-666.
    20. Finocchiaro Castro, Massimo & Ferrara, Paolo Lorenzo & Guccio, Calogero & Lisi, Domenico, 2021. "Optimal mixed payment system and medical liability. A laboratory study," MPRA Paper 110276, University Library of Munich, Germany.
    21. repec:hal:spmain:info:hdl:2441/2jbidihgpo8bia7dbd5ipjlsi9 is not listed on IDEAS
    22. Erin M. Johnson & M. Marit Rehavi, 2016. "Physicians Treating Physicians: Information and Incentives in Childbirth," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 115-141, February.

    More about this item

    Keywords

    Social interactions; Peer effects; Cesarean section; Spatial econometrics;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • C31 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models; Quantile Regressions; Social Interaction Models

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:regeco:v:61:y:2016:i:c:p:1-17. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/regec .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.