IDEAS home Printed from https://ideas.repec.org/p/zbw/rwirep/952.html
   My bibliography  Save this paper

Concentration of hospital capacities and patients' access to care

Author

Listed:
  • Mensen, Anne

Abstract

The concentration of hospital capacities often involves closures of smaller hospital sites. While advocates of hospital concentrations emphasize increased quality of care and cost savings, some people may feel their health care is at risk. In this paper, I analyze the effect of 18 recent hospital closures in Germany on patients' driving times and the probability to be hospitalized. Using an event study approach and rich patient-level data, I estimate the effect for individuals that are affected most by the closure, i.e., people for whom the hospital was the nearest one in their surroundings. My results show that the driving time to the nearest hospital increases slightly for the affected residents indicating that concentrations of hospital capacities do not severely jeopardize accessibility. Nevertheless, the probability to be admitted to a hospital decreases for residents who live in areas where a hospital closed, showing that the closure seems to affect patients' care.

Suggested Citation

  • Mensen, Anne, 2022. "Concentration of hospital capacities and patients' access to care," Ruhr Economic Papers 952, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    • Handle: RePEc:zbw:rwirep:952
    DOI: 10.4419/96973115
    as

    Download full text from publisher

    File URL: https://www.econstor.eu/bitstream/10419/262728/1/1814254234.pdf
    Download Restriction: no
    File URL: https://libkey.io/10.4419/96973115?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
    ---><---

    References listed on IDEAS

    as
    1. Gautam Gowrisankaran & Aviv Nevo & Robert Town, 2015. "Mergers When Prices Are Negotiated: Evidence from the Hospital Industry," American Economic Review, American Economic Association, vol. 105(1), pages 172-203, January.
    2. Kritee Gujral & Anirban Basu, 2019. "Impact of Rural and Urban Hospital Closures on Inpatient Mortality," NBER Working Papers 26182, National Bureau of Economic Research, Inc.
    3. Varkevisser, Marco & van der Geest, Stéphanie A. & Schut, Frederik T., 2012. "Do patients choose hospitals with high quality ratings? Empirical evidence from the market for angioplasty in the Netherlands," Journal of Health Economics, Elsevier, vol. 31(2), pages 371-378.
    4. Pilny, Adam & Mennicken, Roman, 2014. "Does Hospital Reputation Influence the Choice of Hospital?," Ruhr Economic Papers 516, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    5. Corinna Hentschker & Roman Mennicken, 2015. "The Volume‐Outcome Relationship and Minimum Volume Standards – Empirical Evidence for Germany," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 644-658, June.
    6. Mennicken, Roman & Kolodziej, Ingo W.K. & Augurzky, Boris & Kreienberg, Rolf, 2014. "Concentration of gynaecology and obstetrics in Germany: Is comprehensive access at stake?," Health Policy, Elsevier, vol. 118(3), pages 396-406.
    7. Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July.
    8. Avdic, Daniel, 2016. "Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden," Journal of Health Economics, Elsevier, vol. 48(C), pages 44-60.
    9. Honora Smith & Christine Currie & Pornpimol Chaiwuttisak & Andreas Kyprianou, 2018. "Patient choice modelling: how do patients choose their hospitals?," Health Care Management Science, Springer, vol. 21(2), pages 259-268, June.
    10. Sundmacher, Leonie & Fischbach, Diana & Schuettig, Wiebke & Naumann, Christoph & Augustin, Uta & Faisst, Cristina, 2015. "Which hospitalisations are ambulatory care-sensitive, to what degree, and how could the rates be reduced? Results of a group consensus study in Germany," Health Policy, Elsevier, vol. 119(11), pages 1415-1423.
    11. Versteeg, S.E. & Ho, V.K.Y. & Siesling, S. & Varkevisser, M., 2018. "Centralisation of cancer surgery and the impact on patients’ travel burden," Health Policy, Elsevier, vol. 122(9), pages 1028-1034.
    12. Jonas Krämer & Jonas Schreyögg & Reinhard Busse, 2019. "Classification of hospital admissions into emergency and elective care: a machine learning approach," Health Care Management Science, Springer, vol. 22(1), pages 85-105, March.
    Full references (including those not matched with items on IDEAS)

    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. Daniel Avdic & Tugba Bueyuekdurmus & Giuseppe Moscelli & Adam Pilny & Ieva Sriubaite, 2018. "Subjective and objective quality reporting and choice of hospital: Evidence from maternal care services in Germany," CINCH Working Paper Series 1803, Universitaet Duisburg-Essen, Competent in Competition and Health.
    2. Sonia Bhalotra & Letícia Nunes & Rudi Rocha, 2020. "Urgent Care Centers, Hospital Performance and Population Health," Working Papers 10, Instituto de Estudos para Políticas de Saúde.
    3. Avdic, Daniel & Moscelli, Giuseppe & Pilny, Adam & Sriubaite, Ieva, 2019. "Subjective and objective quality and choice of hospital: Evidence from maternal care services in Germany," Journal of Health Economics, Elsevier, vol. 68(C).
    4. Sriubaite, Ieva, 2021. "Who will be the mediator? Local politics and hospital closures in Germany," Ruhr Economic Papers 897, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    5. Tamara Bischof & Boris Kaiser, 2021. "Who cares when you close down? The effects of primary care practice closures on patients," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2004-2025, September.
    6. Bhalotra, Sonia & Nunes, Leticia & Rocha, Rudi, 2023. "Emergency Care Centers, Hospital Performance and Population Health," The Warwick Economics Research Paper Series (TWERPS) 1456, University of Warwick, Department of Economics.
    7. Stefanie Fischer & Heather Royer & Corey White, 2022. "Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the US," Monash Economics Working Papers 2022-06, Monash University, Department of Economics.
    8. Schmid, Andreas & Varkevisser, Marco, 2016. "Hospital merger control in Germany, the Netherlands and England: Experiences and challenges," Health Policy, Elsevier, vol. 120(1), pages 16-25.
    9. Kollerup, Anna, 2022. "Worth the trip? The effect of hospital clinic closures for patients undergoing scheduled surgery," Social Science & Medicine, Elsevier, vol. 314(C).
    10. Balia, Silvia & Brau, Rinaldo & Moro, Daniela, 2020. "Choice of hospital and long-distances: Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 81(C).
    11. Simonsen, Marianne & Skipper, Lars & Skipper, Niels & Thingholm, Peter Rønø, 2021. "Discontinuity in care: Practice closures among primary care providers and patient health care utilization," Journal of Health Economics, Elsevier, vol. 80(C).
    12. Kollerup, Anna & Wadmann, Sarah & Bek, Toke & Kjellberg, Jakob, 2022. "National clinical guidelines and treatment centralization do not guarantee consistency in healthcare delivery. A mixed-methods study of wet age-related macular degeneration treatment in Denmark," Health Policy, Elsevier, vol. 126(12), pages 1291-1302.
    13. Herr, A. & Saric, A., 2016. "The Welfare Effects of Single Rooms in German Nursing Homes: A Structural Approach," Health, Econometrics and Data Group (HEDG) Working Papers 16/23, HEDG, c/o Department of Economics, University of York.
    14. Pilny, Adam & Mennicken, Roman, 2014. "Does Hospital Reputation Influence the Choice of Hospital?," Ruhr Economic Papers 516, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    15. Timo Schulte & Tillmann Wurz & Oliver Groene & Sabine Bohnet-Joschko, 2023. "Big Data Analytics to Reduce Preventable Hospitalizations—Using Real-World Data to Predict Ambulatory Care-Sensitive Conditions," IJERPH, MDPI, vol. 20(6), pages 1-16, March.
    16. Anna-Theresa Renner & Dieter Pennerstorfer, 2020. "Modeling inter-regional patient mobility: Does distance go far enough?," Economics working papers 2020-04, Department of Economics, Johannes Kepler University Linz, Austria.
    17. Abu-Qarn, Aamer & Lichtman-Sadot, Shirlee, 2022. "Can greater access to secondary health care decrease health inequality? Evidence from bus line introduction to Arab towns in Israel," Economic Modelling, Elsevier, vol. 106(C).
    18. Hentschker, Corinna & Mennicken, Roman, 2014. "Selective-referral and Unobserved Patient Heterogeneity – Bias in the Volume-outcome Relationship," Ruhr Economic Papers 527, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    19. Soroush Saghafian & Lina D. Song & Ali S. Raja, 2022. "Towards a more efficient healthcare system: Opportunities and challenges caused by hospital closures amid the COVID-19 pandemic," Health Care Management Science, Springer, vol. 25(2), pages 187-190, June.
    20. 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.

    More about this item

    Keywords

    Hospital closures; access to health care; travel time; concentration process;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • R41 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Transportation Economics - - - Transportation: Demand, Supply, and Congestion; Travel Time; Safety and Accidents; Transportation Noise

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:zbw:rwirep:952. 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: ZBW - Leibniz Information Centre for Economics (email available below). General contact details of provider: https://edirc.repec.org/data/rwiesde.html .

    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.