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Motivated by reasons such as patients’ needs, lack of resources, technologies or skills, and quality, hospital managers may engage in cooperative behaviours. We study the determinants of patients’ transfers, a specific form of cooperation, and quantify its association with the quality delivered by the origin and destination hospital. Using Italian administrative data, we handle the network structure embedded in the data by adopting an over-dispersed Poisson mixed model. The results show a positive relationship between hospital cooperation and quality. The introduction of transferal protocols that exploit information on hospital quality may further improve the overall quality of the healthcare sector.

The association between hospital cooperation and the quality of healthcare