Regional variation in health care utilization and mortality

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Godøy, Anna and Ingrid Huitfeldt




Journal of Health Economics



Geographic variation in health care utilization has raised concerns of possible inefficienciesin health care supply, as differences are often not reflected in health outcomes. Using com-prehensive Norwegian microdata, we exploit cross-region migration to analyze regionalvariation in health care utilization. Our results indicate that place factors account for half ofthe difference in utilization between high and low utilization regions, while the rest reflectspatient demand. We further document heterogeneous impacts of place across socioeco-nomic groups. Place factors account for 75% of the regional utilization difference for highschool dropouts, and 40% for high school graduates; for patients with a college degree, theimpact of place is negligible. We find no statistically significant association between the esti-mated place effects and overall mortality. However, we document a negative associationbetween place effects and utilization-intensive causes of death such as cancer, suggestinghigh-supply regions may achieve modestly improved health outcomes.


Health care supply; Health care demand; Health care spending; Regional variation; Health outcomesa


H51; I1; I11; I13

Prosjekt info:

Oppdragsgiver: NFR via NTNU
Oppdragsgivers prosjektnr.: 214338
Frisch prosjekt: 4115 - The effect of DRG-based financing on hospital