Individual and contextual determinants of inter-regional mobility in cancer patients


Abstract


This paper will present an investigation of inter-regional mobility in patients with a diagnosis of cancer. By virtue of the availability of geocoded information relating to a patient's place of residence, the effect of socio-economic status and other individual characteristics regarding inter-regional mobility will be analysed by means of multilevel logit models. The results demonstrate the influence of age and comorbidity on mobility propensity, in addition to the treatment type, which plays a role in patient mobility. As contextual determinants, patients  residing in less deprived areas show greater mobility than those who reside in materially deprived areas. The extent of patient mobility, and its dependence on their socio-economic status raises issues of equity, as well as regional policy considerations.

DOI Code: 10.1285/i20705948v12n1p14

Keywords: Patient mobility, Equity, Geocoding, Sicily

References


Aggarwal, A., Lewis, D., Mason, M., Sullivan, R., and van der Meulen, J. (2016). Patient mobility for elective secondary healthcare services in response to patient choice policies: A systematic review. Medical Care Research and Review, on-line:1–25.

Ambroggi, M., Biasini, C., Del Giovane, C., Fornari, F., and Cavanna, L. (2015). Distance as a barrier to cancer diagnosis and treatment: review of the literature. The oncologist, 20(12):1378–1385.

Balia, S., Brau, R., and Marrocu, E. (2014). What drives patient mobility across Italian regions? Evidence from hospital discharge data. In Levaggi, R. and Montefiori, M., editors, Healthcare Provision and Patient Mobility. Health integration in the European Union, chapter 12, pages 133–154. Springer-Verlag, Milan.

Balia, S., Brau, R., and Marrocu, E. (2017). Interregional patient mobility in a decentralized healthcare system. Regional Studies, pages 1–15.

Brenna, E. and Spadonaro, F. (2015). Regional incentives and patient ross-border mobility: evidence from the Italian experience. International Journal of Health Policy and Management, 4(6):363–372.

Buntin, M. B., Damberg, C., Haviland, A., Kapur, K., Lurie, N., McDevitt, R., and Marquis, M. S. (2006). Consumer-directed health care: early evidence about effects on cost and quality. Health Affairs, 25(6):w516–w530.

Cantarero, D. (2006). Health care and patients migration across Spanish regions. The European Journal of Health Economics, 7(2):114–116.

Caranci, N., Biggeri, A., Grisotto, L., Pacelli, B., Spadea, T., and Costa, G. (2015). The Italian deprivation index at census block level: definition, description and association with general mortality. International Journal of Health Policy and Management, 4(6):363–372.

Charlson, M. E., Pompei, P., Ales, K. L., and MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of chronic diseases, 40(5):373–383.

Cooper, Z., Gibbons, S., Jones, S., and McGuire, A. (2011). Does hospital competition save lives? Evidence from the English NHS patient choice reforms. The Economic Journal, 121(554).

Fabbri, D. and Robone, S. (2010). The geography of hospital admission in a national health service with patient choice. Health Economics, 19(9):1029–1047.

Fattore, G., Petrarca, G., and Torbica, A. (2014). Traveling for care: Inter-regional mobility for aortic valve substitution in Italy. Health Policy, 117(1):90–97.

Glinos, I. A., Baeten, R., Helble, M., and Maarse, H. (2010). A typology of cross-border patient mobility. Health & Place, 16(6):1145–1155.

Gowrisankaran, G. and Town, R. J. (2003). Competition, payers, and hospital quality. Health Services Research, 38(6p1):1403–1422.

Helena, R. (2016). Cross-border healthcare directive: Assessing stakeholders perspectives in Poland and Portugal. Health Policy, 120(4):369–376.

Kessler, D. P. and McClellan, M. B. (2000). Is hospital competition socially wasteful? The Quarterly Journal of Economics, 115(2):577–615.

Levaggi, R. and Montefiori, M., editors (2014). Healthcare Provision and Patient Mobility. Health integration in the European Union, volume 12, Milan. Springer-Verlag.

McGuirk, M. A. and Porell, F. W. (1984). Spatial patterns of hospital utilization: the impact of distance and time. Inquiry, pages 84–95.

Riedel, R. (2016). European patient’s cross-border mobility directive. Public Health, 139:222–223.

Shen, Y.-C. (2003). The effect of financial pressure on the quality of care in hospitals. Journal of Health Economics, 22(2):243–269.

Stitzenberg, K. B., Sigurdson, E. R., Egleston, B. L., Starkey, R. B., and Meropol, N. J. (2009). Centralization of cancer surgery: implications for patient access to optimal care. Journal of Clinical Oncology, 27(28):4671–4678.

Victoor, A., Delnoij, D. M., Friele, R. D., and Rademakers, J. J. (2012). Determinants of patient choice of healthcare providers: a scoping review. BMC Health Services Research, 12(1):272.


Full Text: pdf


Creative Commons License
This work is licensed under a Creative Commons Attribuzione - Non commerciale - Non opere derivate 3.0 Italia License.