Document Detail


The analysis of a cardiological network in a regulated setting: a spatial interaction approach.
MedLine Citation:
PMID:  17575558     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We analyse referral patterns for patients undergoing percutaneous transluminal coronary angioplasty (PTCA) in the Emilia Romagna region of Italy, a procedure for which the assumption of a negative association between volume and adverse outcomes is used to justify its territorial concentration. Nevertheless, recent clinical evidence shows PTCA superiority for immediate treatment of acute myocardial infarction, which advises an increase in the number of points of delivery. Our paper aims to develop analytical tools designed to provide support to policy makers when they are asked to evaluate the spatial distribution of catheterisation laboratories that perform PTCA. Information is drawn from the regional administrative hospital discharge data (SDO) for the year 2002. We first use entropy indexes to investigate the spatial accessibility of the cardiological network. Secondly, by means of a gravity model estimated using Bayesian techniques we identify the determinants of patient flows in terms of demand and supply factors. Our results suggest that information on destinations is processed hierarchically and that agglomeration-like forces are dominant. Furthermore, although self-sufficiency of provision at the provincial level has been achieved to a large extent, there is still scope to improve the organisational efficiency of the network.
Authors:
Matteo Lippi Bruni; Lucia Nobilio; Cristina Ugolini
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Health economics     Volume:  17     ISSN:  1057-9230     ISO Abbreviation:  Health Econ     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-31     Completed Date:  2008-04-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9306780     Medline TA:  Health Econ     Country:  England    
Other Details:
Languages:  eng     Pagination:  221-33     Citation Subset:  IM    
Affiliation:
Department of Economics, University of Bologna, Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary*
Bayes Theorem
Cardiac Care Facilities / organization & administration*
Female
Humans
Italy
Male
Middle Aged
Referral and Consultation / organization & administration*
Regional Health Planning / organization & administration*
Sex Factors
Socioeconomic Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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