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A model of hospital congestion in developing countries

Author

Listed:
  • Damien Besancenot

    (LIRAES - EA 4470 - Laboratoire Interdisciplinaire de Recherche Appliquée en Economie de la Santé - UPD5 - Université Paris Descartes - Paris 5)

  • Nicolas Sirven

    (IRDES - Institut de Recherche et Documentation en Economie de la Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres, LIRAES - EA 4470 - Laboratoire Interdisciplinaire de Recherche Appliquée en Economie de la Santé - UPD5 - Université Paris Descartes - Paris 5)

  • Radu Vranceanu

    (ESSEC Business School and THEMA (UMR 8184) - ESSEC Business School - THEMA - Théorie économique, modélisation et applications - CNRS - Centre National de la Recherche Scientifique - CY - CY Cergy Paris Université)

Abstract

This paper explains the observed hospital congestion in developing countries as the result of the interaction between ambulatory care physicians who refer patients to hospitals, and hospitals which must detect the severity of the incoming patients'disease. In an imperfect information environment, physicians might refer to top-tier hospitals patients with mild diseases that could be properly addressed by regular hospitals, just to ful ll patients'demand for the best care. Yet, the triage capability of top-tier hospitals declines if the hospital is subject to congestion, which, in turn, provides incentives to physicians to refer more patients to these hospitals. The model presents two equilibria, one with perfect triage, and another with triage errors and hospital congestion. In this last equilibrium, a higher hospital size raises the likelihood of congestion.

Suggested Citation

  • Damien Besancenot & Nicolas Sirven & Radu Vranceanu, 2018. "A model of hospital congestion in developing countries," Working Papers hal-01791106, HAL.
    • Handle: RePEc:hal:wpaper:hal-01791106
    Note: View the original document on HAL open archive server: https://essec.hal.science/hal-01791106v1
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    References listed on IDEAS

    as
    1. Besancenot, Damien & Vranceanu, Radu, 2009. "Multiple equilibria in a firing game with impartial justice," Labour Economics, Elsevier, vol. 16(3), pages 262-271, June.
    2. Hammer, Jeffrey & Jack, William, 2002. "Designing incentives for rural health care providers in developing countries," Journal of Development Economics, Elsevier, vol. 69(1), pages 297-303, October.
    3. Alejandro Arrieta & Jorge Guillén, 2017. "Output congestion leads to compromised care in Peruvian public hospital neonatal units," Health Care Management Science, Springer, vol. 20(2), pages 157-164, June.
    4. Murray, Susan F. & Pearson, Stephen C., 2006. "Maternity referral systems in developing countries: Current knowledge and future research needs," Social Science & Medicine, Elsevier, vol. 62(9), pages 2205-2215, May.
    5. Saed Alizamir & Francis de Véricourt & Peng Sun, 2013. "Diagnostic Accuracy Under Congestion," Management Science, INFORMS, vol. 59(1), pages 157-171, December.
    6. Mwabu, Germano M., 1989. "Referral systems and health care seeking behavior of patients: An economic analysis," World Development, Elsevier, vol. 17(1), pages 85-91, January.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    Hospital congestion; hospital size; referral system; health policy; developing countries;
    All these keywords.

    JEL classification:

    • D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information; Mechanism Design
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I15 - Health, Education, and Welfare - - Health - - - Health and Economic Development

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