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Place or patient as the driver of regional variation in healthcare spending - Discrepancies by category of care
Örebro universitet, Institutionen för hälsovetenskaper. Region Örebro län. University Health Care Research Center.ORCID-id: 0000-0003-2325-5375
Karlstad Business School, Karlstad University, Sweden.
School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Sweden; Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, USA.
2024 (engelsk)Inngår i: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 342, artikkel-id 116571Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

We study how much regional variation in healthcare spending is driven by place- and patient-specific factors using a random sample of 53,620 regional migrants in Sweden. We find notable differences depending on the category of care, with place-specific factors having a significantly larger impact on specialized outpatient care compared to inpatient and pharmaceutical care. The place effect is estimated to 75% of variation in specialized outpatient care, but 26% or less in variations in inpatient care, and 5% in prescription drug spending. We also find that the empirical estimator has a substantial impact on the estimates of the place-specific effect. The results based on the traditional approach in the literature with two-way fixed effects and event-study models produce much larger estimates of the place-specific effect compared to results based on recently developed heterogeneity-robust models. For total healthcare spending, the traditional two-way fixed effects model estimates a place effect of 78%, while the heterogeneity-robust estimator finds a place effect around 10%. This finding indicates that previous results in this literature, all based on traditional two-way fixed-effects regressions, should be interpreted with care.

sted, utgiver, år, opplag, sider
Elsevier, 2024. Vol. 342, artikkel-id 116571
Emneord [en]
Event study, Healthcare spending, Movers, Regional variation, Two-way fixed effects
HSV kategori
Identifikatorer
URN: urn:nbn:se:oru:diva-110708DOI: 10.1016/j.socscimed.2024.116571ISI: 001161924700001PubMedID: 38215643Scopus ID: 2-s2.0-85182385969OAI: oai:DiVA.org:oru-110708DiVA, id: diva2:1827620
Forskningsfinansiär
Swedish Research Council, 2018–02708Tilgjengelig fra: 2024-01-15 Laget: 2024-01-15 Sist oppdatert: 2024-03-04bibliografisk kontrollert

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