TY - JOUR
T1 - Do market incentives for hospitals affect health and service utilization?
T2 - evidence from prospective pay system–diagnosis-related groups tariffs in Italian regions
AU - Cappellari, Lorenzo
AU - De Paoli, Anna
AU - Turati, Gilberto
PY - 2016
Y1 - 2016
N2 - We exploit variation across Italian regions in the implementation of region‐specific tariffs within a prospective pay system for hospitals based on diagnosis‐related groups to assess their effect on health and on the use of healthcare services. We consider survey data for the years 1993–2007 with information on both individuals’ perceived health and their utilization of healthcare services. The results suggest that the introduction of market incentives via a fixed price payment system did not lead to worse health perceptions. Instead, it marked a moderate decrease in hospitalization coupled with a clearer decrease in the utilization of emergency services. We also find mild evidence of reduced satisfaction with healthcare services among hospital patients. These effects were stronger for adoptions occurring when also the national government supported the market‐based approach. Results are robust to sensitivity checks.
AB - We exploit variation across Italian regions in the implementation of region‐specific tariffs within a prospective pay system for hospitals based on diagnosis‐related groups to assess their effect on health and on the use of healthcare services. We consider survey data for the years 1993–2007 with information on both individuals’ perceived health and their utilization of healthcare services. The results suggest that the introduction of market incentives via a fixed price payment system did not lead to worse health perceptions. Instead, it marked a moderate decrease in hospitalization coupled with a clearer decrease in the utilization of emergency services. We also find mild evidence of reduced satisfaction with healthcare services among hospital patients. These effects were stronger for adoptions occurring when also the national government supported the market‐based approach. Results are robust to sensitivity checks.
U2 - https://doi.org/10.1111/rssa.12204
DO - https://doi.org/10.1111/rssa.12204
M3 - Article
SN - 0964-1998
VL - 179
SP - 885
EP - 905
JO - Journal of the Royal Statistical Society. Series A: Statistics in Society
JF - Journal of the Royal Statistical Society. Series A: Statistics in Society
IS - 4
ER -