Renner, A.-T., & Wang, Y. (2023, October 23). Patient choice and hospital quality: Is there a neighbourhood effect? [Presentation]. Dondena Seminar Series at the Bocconi University 2023, Mailand, Italy.
We investigate how hospital choice for elective hip replacement surgery is influenced by adverse events experienced by patients from the same neighbourhood, compared to adverse events experienced by all observed patients. We exploit a dataset of all elderly Italian patients who underwent elective hip replacement surgery from 2010 to 2015. Using a patient-level random utility choice model we find that - independent of the overall quality of a hospital - patients are more likely to choose hospitals with a low rate of "local" adverse events, proxied by in-hospital mortality, of patients from the same municipality. This holds for rural and urban regions, and is robust to a set sensitivity checks. Our results suggest that, in the absence of official statistics, patients do not select hospitals with the highest treatment quality, but rather avoid those where their neighbours experienced adverse events.