Proximity and waiting times in choice models for outpatient cardiological visits in Italy

Seghieri, Chiara; Calovi, Martina; Ferrè, Francesca

doi:10.1371/journal.pone.0203018

Cited by 11 publications

(13 citation statements)

References 21 publications

(29 reference statements)

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“…Similar to other Italian Regions, Tuscany has a non-competitive Health Service where patients are free to choose the provider. Studies on patient choice can either employ data from survey, where individuals are asked to choose between different hypothetical scenarios or to report about recent health-related episodes (stated preferences) [ 42 ], or administrative data, which allow to retrospectively analyze the choice of patients accessing health services (revealed preferences) [ 21 ]. Particularly, this paper used anonymized individual-level administrative health data (namely, Regional Hospital Discharge Records) to examine the relationship between travel and waiting times, as well as hospital efficiency and quality, and the hospital choice of patients who received POP surgery in Tuscany from 2017 to 2019.…”

Section: Methodsmentioning

confidence: 99%

“…We generated a dichotomous variable hospital choice assuming the value one when the hospital where the patient was operated on coincided with one of the 22 hospitals. Otherwise, the value was zero [ 21 ]. Between-hospital patient choice was explored through mixed logit models, which properly allow to account for heterogeneity in preferences by enabling coefficients to vary between patients and relaxing the assumption of independence from irrelevant alternatives [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

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Driving time drives the hospital choice: choice models for pelvic organ prolapse surgery in Italy

et al. 2023

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Objective The Italian healthcare jurisdiction promotes patient mobility, which is a major determinant of practice variation, thus being related to the equity of access to health services. We aimed to explore how travel times, waiting times, and other efficiency- and quality-related hospital attributes influenced the hospital choice of women needing pelvic organ prolapse (POP) surgery in Tuscany, Italy. Methods We obtained the study population from Hospital Discharge Records. We duplicated individual observations (n = 2533) for the number of Tuscan hospitals that provided more than 30 POP interventions from 2017 to 2019 (n = 22) and merged them with the hospitals’ list. We generated the dichotomous variable “hospital choice” assuming the value one when hospitals where patients underwent surgery coincided with one of the 22 hospitals. We performed mixed logit models to explore between-hospital patient choice, gradually adding the women’s features as interactions. Results Patient choice was influenced by travel more than waiting times. A general preference for hospitals delivering higher volumes of interventions emerged. Interaction analyses showed that poorly educated women were less likely to choose distant hospitals and hospitals providing greater volumes of interventions compared to their counterpart. Women with multiple comorbidities more frequently chose hospitals with shorter average length of stay. Conclusion Travel times were the main determinants of hospital choice. Other quality- and efficiency-related hospital attributes influenced hospital choice as well. However, the effect depended on the socioeconomic and clinical background of women. Managers and policymakers should consider these findings to understand how women behave in choosing providers and thus mitigate equity gaps.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Driving time drives the hospital choice: choice models for pelvic organ prolapse surgery in Italy

et al. 2023

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“…It has been proved [ 27 ] that a higher income is associated with a greater willingness to travel, although there is a saturation point (distance) beyond which the income effect is greatly reduced [ 28 ]. However, variables such as lower level of education, older age, and female gender negatively affect the choice of the healthcare facility and the propensity to travel long distances for care [ 29 , 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

Inter-Regional Hospital Patients’ Mobility in Italy

et al. 2021

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Background: The federalization of the Italian National Health Service (NHS) gave administrative, financial, and managerial independence to regions. They are in reciprocal competition according to the “quasi-market” model. A network of independent providers replaced the state monopoly. The NHS, based on the Beveridge model in which citizens are free to choose their place of treatment, was consolidated. The aim of our research was to analyze the fulfillment of need for hospital services on site and patients’ migration to hospitals of other regions. Material and Methods: We analyzed data from 2013 to 2017 of Hospital Discharge Cards (HDCs) provided by the Ministry of Health. The subjects of the analysis (catchment areas) were the hospital networks of every Italian region. The study of flows was developed through Internal Demand Satisfaction, Attraction, Escape, Attraction, Absorption, and Escape Production indexes. Graphic representations were produced using Gandy’s Nomogram and Qgis software. Results: In the studied period, the mean number of mobility admission was 678.659 ± 3.388, with an increase of 0.90%; in particular, the trend for ordinary regime increased 1.17%. Regions of central/northern Italy have attracted more than 60% of the escapes of the southern ones. Gandy’s Nomogram showed that only nine regions had optimal public hospital planning (Lombardy, Autonomous Province of Bolzano, Veneto, Friuli V.G., Emilia-Romagna, Tuscany, Umbria, Latium and Molise). Conclusion: The central/northern regions appear more able to meet the care needs of their citizens and to attract patients than the southern ones.

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“…China’s medical system is obviously defined based on Chinese characteristics. In European and North American countries [11–13], most clinicians require patients to make appointments in advance for medical consultations. If a patient has a disease but no emergent condition, the primary care provider directly contacts a specialist in a hospital and makes arrangements for further diagnosis and treatment of the patient.…”

Section: Discussionmentioning

confidence: 99%

Effects of a comprehensive reservation service for non-emergency registration on appointment registration rate, patient waiting time, patient satisfaction and outpatient volume in a tertiary hospital in China

Xie

Yang

Cao

et al. 2019

BMC Health Serv Res

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Background: In China, a long waiting time for registration is a common occurrence in many tertiary hospitals. This study aimed to analyze the effects of a comprehensive reservation service for non-emergency registration on appointment registration rate, patient waiting time, patient satisfaction and outpatient volume at the Guangzhou Women and Children's Medical Center. Methods: This was a cross-sectional study. This study investigated the effects of a comprehensive reservation service for non-emergency registration in Guangzhou Women and Children's Medical Center in China starting in October 2015. In total, 2194 patients completed a satisfaction survey administered by the Guangdong Situation Research Center. The content of the questionnaire consisted of six aspects: general impression, service attitude, service quality, hospital environment, price perception and medical ethics. A Likert 5-point rating scale was used in the questionnaire; answers were classified as "very satisfied", "relatively satisfied", "neutral", "unsatisfied" and "very unsatisfied". The method of application was paper-based. T-tests were used to compare the sample means, and chisquare tests were used to compare the rates. A multiple-test procedure was performed to evaluate the differences in the reservation rates during a 12-month period. Results: After the implementation of the comprehensive reservation service for non-emergency registration in our hospital, which has an annual outpatient volume of approximately 4 million, the monthly appointment registration rate increased from (34.95 ± 2.91)% to(89.13 ± 3.12)%,P < 0.01. The patient waiting time was significantly reduced (P < 0.01), and the proportion of patients who believed that the waiting time required improvement was decreased significantly (P < 0.01). Moreover, the third-party evaluation result of outpatient satisfaction significantly improved (P < 0.01). The total hospital outpatient volume decreased(P < 0.01). The outpatient volume of the Department of General Pediatrics decreased.

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Proximity and waiting times in choice models for outpatient cardiological visits in Italy

Cited by 11 publications

References 21 publications

Driving time drives the hospital choice: choice models for pelvic organ prolapse surgery in Italy

Driving time drives the hospital choice: choice models for pelvic organ prolapse surgery in Italy

Inter-Regional Hospital Patients’ Mobility in Italy

Effects of a comprehensive reservation service for non-emergency registration on appointment registration rate, patient waiting time, patient satisfaction and outpatient volume in a tertiary hospital in China

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