Spatial Competition Across Borders: The Role of Patients’ Mobility and Institutional Settings
Health care systems rely on geographical boundaries that secure financial stability and adequate planning. Quality differences across regions often arise for efficiency reasons, causing patient flows if mobility is free. In this paper, a theoretical spatial competition model is developed to study th...
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MDPI AG
2025-06-01
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| author | Laura Levaggi Rosella Levaggi |
| author_facet | Laura Levaggi Rosella Levaggi |
| author_sort | Laura Levaggi |
| collection | DOAJ |
| description | Health care systems rely on geographical boundaries that secure financial stability and adequate planning. Quality differences across regions often arise for efficiency reasons, causing patient flows if mobility is free. In this paper, a theoretical spatial competition model is developed to study the role of patients’ mobility on quality setting and to draw policy implications on its use as an instrument to reduce disparities, in a setting where regions differ in efficiency, costs, and market structure. From the analysis, it emerges that the institutional setting matters and a trade-off may appear between equity (in terms of quality difference across patients) and welfare (finding an allocation that maximizes social benefits). In a centralized setting, it is optimal to regulate mobility and increase the quality gap, while allowing free mobility calls for a refined quality setting, in which, depending on a balance between costs and benefits, the quality gap may be either increased or decreased. In decentralization the gap is generally lower, compared to centralization: the different consideration of benefits from local quality provision results in higher quality levels where the market structure is vertically integrated. |
| format | Article |
| id | doaj-art-7faf24e54e3c439594f65dbd5b68f861 |
| institution | OA Journals |
| issn | 2073-4336 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Games |
| spelling | doaj-art-7faf24e54e3c439594f65dbd5b68f8612025-08-20T02:21:02ZengMDPI AGGames2073-43362025-06-011633110.3390/g16030031Spatial Competition Across Borders: The Role of Patients’ Mobility and Institutional SettingsLaura Levaggi0Rosella Levaggi1Faculty of Engineering, Free University of Bolzano-Bozen, Via Buozzi 1, 39100 Bolzano-Bozen, ItalyDepartment of Economics and Management, University of Brescia, Via S. Faustino, 74b, 25122 Brescia, ItalyHealth care systems rely on geographical boundaries that secure financial stability and adequate planning. Quality differences across regions often arise for efficiency reasons, causing patient flows if mobility is free. In this paper, a theoretical spatial competition model is developed to study the role of patients’ mobility on quality setting and to draw policy implications on its use as an instrument to reduce disparities, in a setting where regions differ in efficiency, costs, and market structure. From the analysis, it emerges that the institutional setting matters and a trade-off may appear between equity (in terms of quality difference across patients) and welfare (finding an allocation that maximizes social benefits). In a centralized setting, it is optimal to regulate mobility and increase the quality gap, while allowing free mobility calls for a refined quality setting, in which, depending on a balance between costs and benefits, the quality gap may be either increased or decreased. In decentralization the gap is generally lower, compared to centralization: the different consideration of benefits from local quality provision results in higher quality levels where the market structure is vertically integrated.https://www.mdpi.com/2073-4336/16/3/31cross-border patients’ mobilityspatial competitioncentralized vs. decentralized provision |
| spellingShingle | Laura Levaggi Rosella Levaggi Spatial Competition Across Borders: The Role of Patients’ Mobility and Institutional Settings Games cross-border patients’ mobility spatial competition centralized vs. decentralized provision |
| title | Spatial Competition Across Borders: The Role of Patients’ Mobility and Institutional Settings |
| title_full | Spatial Competition Across Borders: The Role of Patients’ Mobility and Institutional Settings |
| title_fullStr | Spatial Competition Across Borders: The Role of Patients’ Mobility and Institutional Settings |
| title_full_unstemmed | Spatial Competition Across Borders: The Role of Patients’ Mobility and Institutional Settings |
| title_short | Spatial Competition Across Borders: The Role of Patients’ Mobility and Institutional Settings |
| title_sort | spatial competition across borders the role of patients mobility and institutional settings |
| topic | cross-border patients’ mobility spatial competition centralized vs. decentralized provision |
| url | https://www.mdpi.com/2073-4336/16/3/31 |
| work_keys_str_mv | AT lauralevaggi spatialcompetitionacrossborderstheroleofpatientsmobilityandinstitutionalsettings AT rosellalevaggi spatialcompetitionacrossborderstheroleofpatientsmobilityandinstitutionalsettings |