Hospital closure in urban and rural areas and patients’ welfare

TY - JOUR

T1 - Hospital closure in urban and rural areas and patients’ welfare

AU - Gravelle, Hugh Stanley Emrys

AU - Moscelli, Giuseppe

AU - Santos, Rita

AU - Siciliani, Luigi

N1 - © 2024 The Authors

PY - 2024/11/14

Y1 - 2024/11/14

N2 - The hospital sector is frequently subject to reconfigurations, with some departments closing and new ones opening. Using a conditional logit model based on observed patient choices, we quantify the effects of a hospital department closure on the welfare of elective hip replacement patients in England. We simulate eight separate closures of the provider with lowest quality, as measured by one of four quality measures: revisions, emergency readmissions, 30-day mortality, change in the Oxford Hip Score, in urban and rural areas. The average reduction in welfare for patients who attended the closed hospital is equivalent to having to travel between two and ten additional kilometres for treatment, compared to their average travel distance, pre-closure, of 17.4 kilometres. The reduction in patient welfare is generally more pronounced when closing a hospital in a rural area (about 50% higher when quality is measured by the Oxford Hip Score and emergency readmissions).

AB - The hospital sector is frequently subject to reconfigurations, with some departments closing and new ones opening. Using a conditional logit model based on observed patient choices, we quantify the effects of a hospital department closure on the welfare of elective hip replacement patients in England. We simulate eight separate closures of the provider with lowest quality, as measured by one of four quality measures: revisions, emergency readmissions, 30-day mortality, change in the Oxford Hip Score, in urban and rural areas. The average reduction in welfare for patients who attended the closed hospital is equivalent to having to travel between two and ten additional kilometres for treatment, compared to their average travel distance, pre-closure, of 17.4 kilometres. The reduction in patient welfare is generally more pronounced when closing a hospital in a rural area (about 50% higher when quality is measured by the Oxford Hip Score and emergency readmissions).

U2 - 10.1016/j.regsciurbeco.2024.104064

DO - 10.1016/j.regsciurbeco.2024.104064

M3 - Article

SN - 0166-0462

VL - 109

JO - Regional Science and Urban Economics

JF - Regional Science and Urban Economics

M1 - 104064

ER -