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Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden
journal contribution
posted on 2022-12-08, 23:35 authored by D AvdicRecent 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.
History
Journal
Journal of Health EconomicsVolume
48Pagination
44-60Location
NetherlandsPublisher DOI
ISSN
0167-6296eISSN
1879-1646Language
enPublisher
Elsevier BVUsage metrics
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Keywords
DistanceHeart attackQuality of careRegionalizationSpatial sortingDelivery of Health CareGeographyHealth Facility ClosureHumansMyocardial InfarctionQuality of Health CareSwedenHeart Disease - Coronary Heart DiseaseHealth ServicesCardiovascularEmergency CareHeart DiseasePatient SafetyClinical Research8.1 Organisation and delivery of servicesGeneric health relevance3 Good Health and Well BeingApplied Economics not elsewhere classifiedPublic Health and Health Services not elsewhere classifiedEconometrics not elsewhere classified
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