A Multinomial Logit Model for the Spatial Distribution of Hospital Utilization

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Abstract
Effective planning and management of multi-institutional health care systems require models to explain and predict hospital utilization in a region. In this study, a multinomial logit model has been formulated and estimated for inpatient hospital utilization in a region. Various measures and indexes that account for the relative attractiveness of hospitals are used in the specification of the model. A data base of more than 130,000 patient records is used to estimate the model. The model provides a good fit of the data and yields insights of particular interest to health planners and hospital administrators. The study also shows that acceptable estimation results can be obtained by careful selection of the estimation method, the procedures for dealing with zero frequencies, and the independent variables.