Hospitals' strategic behaviours and patient mobility: Evidence from Italy.

This study explores the behaviour of hospitals in Lombardy in attracting patients from outside the region and investigates the effects on the quality of care to regional patients, where treatment of the latter is constrained by a budget cap while extra-regional patients represent an unconstrained source of revenue. The data suggest that hospitals use waiting time and length of stay to attract extra-regional patients. Regional patients in both private and public hospitals with higher proportions of extra-regional patients are characterized by lower mortality rates and reimbursement costs. These results suggest that the market for extra-regional patients has no negative effects on resident patients. Finally, the pattern of reimbursement for extra-regional care generates a financial flow in favour of wealthier regions, exacerbating the North–South divide in the National Health Service. Some form of regulation for extra-regional mobility is advisable to reduce the gap. • We study the effects of patients mobility on quality and price for hospital care in Italy. • Hospitals attract patients from southern regions through better quality and from border regions through lower waiting times. • Resident patients are not discriminated and enjoy higher quality. • The price to treat patients from southern regions is higher than for resident. • Some form of regulation in cross border patients mobility might be advisable. [ABSTRACT FROM AUTHOR]