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Patient mobility and health care quality when regions and patients differ in income

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Resumo:We study the effects of cross-border patient mobility on health care quality and welfare when income varies across and within regions. We use a Salop model with a high-, middle-, and low-income region. In each region, a policy maker chooses health care quality to maximise the utility of its residents when health care costs are financed by general income taxation. In equilibrium, regions with higher income offer better quality, which creates an incentive for patient mobility from lower- to higher-income regions. Assuming a prospective payment scheme based on DRG-pricing, we find that lower non-monetary (administrative) mobility costs have (i) no effect on quality or welfare in the high-income region; (ii) a negative effect on quality but a positive effect on welfare for the middle-income region; and (iii) ambiguous effects on quality and welfare for the low-income region. Lower monetary mobility costs (copayments) might reduce welfare in both the middle- and low-income region. Thus, health policies that stimulate cross-border patient mobility can be counterproductive when regions differ in income.
Autores principais:Brekke, Kurt R.
Outros Autores:Levaggi, Rosella; Siciliani, Luigi; Straume, Odd Rune
Assunto:Patient mobility Health care quality Income inequalities Regional welfare Salop model Ciências Sociais::Economia e Gestão
Ano:2016
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso restrito
Instituição associada:Universidade do Minho
Idioma:inglês
Origem:RepositóriUM - Universidade do Minho
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author Brekke, Kurt R.
author2 Levaggi, Rosella
Siciliani, Luigi
Straume, Odd Rune
author2_role author
author
author
author_facet Brekke, Kurt R.
Levaggi, Rosella
Siciliani, Luigi
Straume, Odd Rune
author_role author
contributor_name_str_mv RepositóriUM - Universidade do Minho
country_str PT
creators_json_txt [{\"Person.name\":\"Brekke, Kurt R.\"},{\"Person.name\":\"Levaggi, Rosella\"},{\"Person.name\":\"Siciliani, Luigi\"},{\"Person.name\":\"Straume, Odd Rune\"}]
datacite.contributors.contributor.contributorName.fl_str_mv RepositóriUM - Universidade do Minho
datacite.creators.creator.creatorName.fl_str_mv Brekke, Kurt R.
Levaggi, Rosella
Siciliani, Luigi
Straume, Odd Rune
datacite.date.Accepted.fl_str_mv 2016-12-01T00:00:00Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_16ec
datacite.subjects.subject.fl_str_mv Patient mobility
Health care quality
Income inequalities
Regional welfare
Salop model
Ciências Sociais::Economia e Gestão
datacite.titles.title.fl_str_mv Patient mobility and health care quality when regions and patients differ in income
dc.contributor.none.fl_str_mv RepositóriUM - Universidade do Minho
dc.creator.none.fl_str_mv Brekke, Kurt R.
Levaggi, Rosella
Siciliani, Luigi
Straume, Odd Rune
dc.date.Accepted.fl_str_mv 2016-12-01T00:00:00Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv https://hdl.handle.net/1822/43175
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Elsevier
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_16ec
dc.subject.none.fl_str_mv Patient mobility
Health care quality
Income inequalities
Regional welfare
Salop model
Ciências Sociais::Economia e Gestão
dc.title.fl_str_mv Patient mobility and health care quality when regions and patients differ in income
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description We study the effects of cross-border patient mobility on health care quality and welfare when income varies across and within regions. We use a Salop model with a high-, middle-, and low-income region. In each region, a policy maker chooses health care quality to maximise the utility of its residents when health care costs are financed by general income taxation. In equilibrium, regions with higher income offer better quality, which creates an incentive for patient mobility from lower- to higher-income regions. Assuming a prospective payment scheme based on DRG-pricing, we find that lower non-monetary (administrative) mobility costs have (i) no effect on quality or welfare in the high-income region; (ii) a negative effect on quality but a positive effect on welfare for the middle-income region; and (iii) ambiguous effects on quality and welfare for the low-income region. Lower monetary mobility costs (copayments) might reduce welfare in both the middle- and low-income region. Thus, health policies that stimulate cross-border patient mobility can be counterproductive when regions differ in income.
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fulltext.url.fl_str_mv https://repositorium.uminho.pt/bitstreams/1637a018-2c88-4265-8444-988d706b6e1f/download
id rum_c6c3f495efbbb4ad40f99c257ab1ca21
identifier.url.fl_str_mv https://hdl.handle.net/1822/43175
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institution Universidade do Minho
instname_str Universidade do Minho
language eng
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oai_identifier_str oai:repositorium.uminho.pt:1822/43175
organization_str_mv urn:organizationAcronym:repositorium
person_str_mv Brekke, Kurt R.
Levaggi, Rosella
Siciliani, Luigi
Straume, Odd Rune
publishDate 2016
publisher.none.fl_str_mv Elsevier
reponame_str RepositóriUM - Universidade do Minho
repository_id_str urn:repositoryAcronym:rum
service_str_mv urn:repositoryAcronym:rum
spelling engElsevierporWe study the effects of cross-border patient mobility on health care quality and welfare when income varies across and within regions. We use a Salop model with a high-, middle-, and low-income region. In each region, a policy maker chooses health care quality to maximise the utility of its residents when health care costs are financed by general income taxation. In equilibrium, regions with higher income offer better quality, which creates an incentive for patient mobility from lower- to higher-income regions. Assuming a prospective payment scheme based on DRG-pricing, we find that lower non-monetary (administrative) mobility costs have (i) no effect on quality or welfare in the high-income region; (ii) a negative effect on quality but a positive effect on welfare for the middle-income region; and (iii) ambiguous effects on quality and welfare for the low-income region. Lower monetary mobility costs (copayments) might reduce welfare in both the middle- and low-income region. Thus, health policies that stimulate cross-border patient mobility can be counterproductive when regions differ in income.application/pdfporPatient mobility and health care quality when regions and patients differ in incomeBrekke, Kurt R.Levaggi, RosellaSiciliani, LuigiStraume, Odd RuneHostingInstitutionOrganizationalRepositóriUM - Universidade do Minhoe-mailmailto:repositorium@usdb.uminho.ptrepositorium@usdb.uminho.ptPMID27344297ISSNIsPartOf0167-6296DOIIsPartOf10.1016/j.jhealeco.2016.05.0032016-122016-12-01T00:00:00ZHandlehttps://hdl.handle.net/1822/43175http://purl.org/coar/access_right/c_16ecrestricted accessPatient mobilityHealth care qualityIncome inequalitiesRegional welfareSalop modelhttp://www.oecd.org/science/inno/38235147.pdfFields of Science and Technology (FOS)Ciências Sociais::Economia e Gestão536179 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_16ecapplication/pdffulltexthttps://repositorium.uminho.pt/bitstreams/1637a018-2c88-4265-8444-988d706b6e1f/download
spellingShingle Patient mobility and health care quality when regions and patients differ in income
Brekke, Kurt R.
Patient mobility
Health care quality
Income inequalities
Regional welfare
Salop model
Ciências Sociais::Economia e Gestão
status SINGLETON
subject.fl_str_mv Patient mobility
Health care quality
Income inequalities
Regional welfare
Salop model
subject.other.fl_str_mv Ciências Sociais::Economia e Gestão
title Patient mobility and health care quality when regions and patients differ in income
title_full Patient mobility and health care quality when regions and patients differ in income
title_fullStr Patient mobility and health care quality when regions and patients differ in income
title_full_unstemmed Patient mobility and health care quality when regions and patients differ in income
title_short Patient mobility and health care quality when regions and patients differ in income
title_sort Patient mobility and health care quality when regions and patients differ in income
topic Patient mobility
Health care quality
Income inequalities
Regional welfare
Salop model
Ciências Sociais::Economia e Gestão
topic_facet Patient mobility
Health care quality
Income inequalities
Regional welfare
Salop model
Ciências Sociais::Economia e Gestão
url https://hdl.handle.net/1822/43175
visible 1