Journal Article

The hospital emigration to another region in the light of the environmental, social and governance model in Italy during the period 2004-2021

Resta, Emanuela, Costantiello, Alberto, Leogrande, Angelo, Resta, Onofrio

2024

Overview

The following article presents an analysis of the impact of the Environmental, Social and Governance-ESG determinants on Hospital Emigration to Another Region-HEAR in the Italian regions in the period 2004-2021. The data are analysed using Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled Ordinary Least Squares-OLS, Weighted Least Squares-WLS, and Dynamic Panel at 1 Stage. Furthermore, to control endogeneity we also created instrumental variable models for each component of the ESG model. Results show that HEAR is negatively associated to the E, S and G component within the ESG model. The data were subjected to clustering with a k-Means algorithm optimized with the Silhouette coefficient. The optimal clustering with k=2 is compared to the sub-optimal cluster with k=3. The results suggest a negative relationship between the resident population and hospital emigration at regional level. Finally, a prediction is proposed with machine learning algorithms classified based on statistical performance. The results show that the Artificial Neural Network-ANN algorithm is the best predictor. The ANN predictions are critically analyzed in light of health economic policy directions.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Algorithms / Analysis / Artificial neural networks / Biostatistics / Cluster Analysis / Clustering / Data analysis / Data mining / Econometrics / Economic policy / Emigration / Emigration and immigration / Emigration and Immigration - statistics & numerical data / Environment / Environmental aspects / Environmental governance / Environmental Health / Environmental impact / Epidemiology / Governance / Health care access / Health care expenditures / Health services / Hospital emigration / Hospitals / Hospitals - statistics & numerical data / Humans / Impact analysis / Instrumental variable estimation / Italy / Least squares / Low income groups / Machine learning / Medicine / Medicine & Public Health / Neural networks / Neural Networks, Computer / Nurses / Panel data / Patients / Physicians / Public Health / Random effects / Regional inequalities / Regions / Social aspects / Statistical analysis / Tourism / Vaccine