ABSTRACT
Health services are situated at discrete points in space. Hospitals, nursing homes and emergency rooms provide their services over few locations. Moreover the presence of scale economies due to indivisibilities and learning-by-doing effects embedded in health production to some extent makes the spatial concentration of health service production socially desirable. However the resultant uneven distribution in accessibility costs to such services might constitute a major concern to policy makers. This issue is particularly problematic within universal health systems, in which complete health insurance coverage is guaranteed to the population against the payment of income-based premiums, whenever a major restructuring of the hospital network is invoked for financial reasons. Patients who have similar health conditions and who pay similar premiums, might incur different accessibility costs to hospital, according to where they reside.
