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Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden
Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation. CINCH, Essen, Germany.;Univ Duisburg Essen, Essen, Germany..
2016 (English)In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 48, 44-60 p.Article in journal (Refereed) PublishedText
Abstract [en]

Recent health care consolidation trends raise the important policy question whether improved emergency medical services and enhanced productivity can offset adverse quality effects from decreased access. This paper empirically analyzes how geographical distance from an emergency hospital affects the probability of surviving an acute myocardial infarction (AMI), accounting for health-based spatial sorting and data limitations on out-of-hospital mortality. Exploiting policy-induced variation in hospital distance derived from emergency hospital closures and detailed Swedish mortality data over two decades, results show a drastically decreasing probability of surviving an AMI as residential distance from a hospital increases one year after a closure occurred. The effect disappears in subsequent years, however, suggesting that involved agents quickly adapted to the new environment.

Place, publisher, year, edition, pages
2016. Vol. 48, 44-60 p.
Keyword [en]
Heart attack, Distance, Quality of care, Regionalization, Spatial sorting
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
URN: urn:nbn:se:uu:diva-300053DOI: 10.1016/j.jhealeco.2016.02.002ISI: 000379093600004PubMedID: 27060525OAI: oai:DiVA.org:uu-300053DiVA: diva2:950766
Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-0826 2013-2482
Available from: 2016-08-02 Created: 2016-08-02 Last updated: 2016-08-02Bibliographically approved

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