Regional incentives and patient cross-border mobility: evidence from the Italian experience

• DOI: 10.15171/ijhpm.2015.65
• Publication Date: 2015-05-25T07:32:22Z
• Authors: Elenka Brenna; Federico Spandonaro
• Keywords: Tiebout model; Excellence; Equity; Directive; Reimbursement; Sample (material); Empirical Research

Background In recent years, accreditation of private hospitals followed by decentralisation the Italian National Health Service (NHS) into 21 regional health systems has provided a good empirical ground for investigating Tiebout principle “voting with their feet”. We examine infra-regional trade-off between greater patient choice (due to an increase in hospital services supply) and financial equilibrium, we relate it significant phenomenon Cross-Border Mobility (CBM) regions. Focusing on rules supervising agreements authorities providers care, find incentives accredited attracting inflows. Methods The analysis is undertaken from institutional, regulatory perspective. select sample five regions higher positive CBM balance regulations governing contractual purchasers care. According this sample, provide statistical apply Regional Attraction Ability Index (RAAI), aimed at testing preferences private/public providers. Results that index systematically providers, both case distance/boundary patients excellence/general hospitals. Conclusion Conclusions address issues regarding coverage healthcare equity access. They also raise concerns new European Union (EU) directive inherent mobility across Europe.