Excessive lengths of hospital stay are among the leading sources of inefficiency in healthcare. One reason for excessive lengths of hospital stay is bed-blocking. Bed-blocking occurs when a patient is clinically fit to be discharged but requires some form of support outside the hospital, which is not readily available. The patient remains in the hospital until a safe discharge is possible, resulting in longer lengths of stay. I study whether long-term care (LTC) provision reduces hospital bed-blocking. Using individual data on emergency inpatient admissions at Portuguese hospitals during 2000-2015, I implement a triple-differences design. This design exploits variation in the timing of entry of LTC providers across regions originating from the staggered introduction of the public LTC Network. It also exploits variation in lengths of stay between regular patients and patients exhibiting social factors that put them at risk of bed-blocking, such as living alone, having no family to care, and having inadequate housing. I find that the entry of home-care teams in a region reduces the length of stay of individuals living alone and those with inadequate housing by 4 days relative to regular patients. These reductions in length of stay do not affect the treatment received while at the hospital and and are not associated with increased likelihood of a readmission. Reductions in length of stay upon the entry of nursing homes occur only for patients with high care needs. The beds freed up by bed-blockers are used to admit additional elective patients.

We study disease control in a game of imperfect information. While disease control games of perfect information tend to have multiple equilibria, we show that even a small amount of uncertainty leads to equilibrium uniqueness. In equilibrium, an epidemic may occur even though it is ineffcient and could have been avoided. Moreover, less harmful diseases may cause more deaths. We extend the game to study cooperation and let a subset of players commit to control the disease whenever the expected benefit of doing so is sufficiently high. The equilibrium is again unique. Selection of a more favorable equilibrium is facilitated by this type of cooperation.

In the last two decades, many European countries allowed the sale of Over-the- Counter (OTC) drugs outside pharmacies. This was expected to lower retail prices through increased competition. Evidence of such price reductions is scarce. We assess the impact of supermarket and outlet entry in the OTC drug market on OTC prices charged by incumbent pharmacies using a difference-in-differences strategy. We use price data on five popular OTC drugs for all retailers located in Lisbon for three distinct points in time (2006, 2010, and 2015). Our results suggest that competitive pressure in the market is mainly exerted by supermarkets, which charge, on average, 20% lower prices than pharmacies. The entry of a supermarket among the main competitors of an incumbent pharmacy is associated with an average 4 to 6% decrease in prices relative to the control group. These price reductions are long-lasting, but fairly localized. We find no evidence of price reductions following OTC outlet entry. Additional results from a reduced-form entry model and a propensity score matching difference-in-differences approach support the view that these effects are causal.

We assess the relative importance of demand and supply factors as determinants of regional variation in healthcare expenditures in the Netherlands. Our empirical approach follows individuals who migrate between regions. We use individual data on annual healthcare expenditures for the entire Dutch population between the years 2006 and 2013. Regional variation in healthcare expenditures is mostly driven by demand factors, with an estimated share of around 70%. Both demographics and other unobserved demand factors, e.g. patient preferences, are important components of the demand share. The relative importance of different causes varies with the groups of regions being compared.

We evaluate the evolution of the socioeconomic inequalities regarding registration with family physicians in Portugal between 2009 and 2014. We use data at the primary health care unit level on the number of individuals who are not registered with a family physician and the purchasing power of the population served by each unit. The analysis is done using concentration measures. We find a higher concentration of individuals not registered with a family physician among units serving populations with higher socioeconomic status, although this has been decreasing over the years analyzed. Amongst units serving the most disadvantaged populations, we find a situation close to perfect equality. Our findings convey a reduction in existing socioeconomic inequalities in terms of registration with a primary care physician, during the period under analysis. This reduction took place among the populations which experienced more inequality.