Prof Vincenzo Carrieri, Prof. Antonella Ferrara (p), Prof Raffaele Lagravinese

Objectives
This paper examines the spatial equilibrium effects of hospital department downsizing in Italy following the large-scale restructuring of the hospital network triggered by the 2008 financial crisis. The study aims to assess how large and persistent reductions in bed capacity affect healthcare delivery beyond the directly treated hospitals, with a focus on spillover effects on neighbouring same-specialty departments. In particular, it investigates changes in activity levels, congestion, quality of care, and patient mobility across local hospital markets, while accounting for heterogeneity across hospital ownership types and geographic areas.
Methodology
The analysis uses a novel ward-level dataset covering all medical specializations in Italy over the period 2015–2022. Identification exploits the staggered timing and geographic dispersion of hospital department downsizing events within a difference-in-differences framework. The empirical specification includes rich sets of fixed effects and hospital-clustered standard errors. Outcomes of interest include bed utilization, discharges, surgical activity, lengths of stay, mortality indicators, and patient mobility, allowing for a comprehensive assessment of both capacity reallocation and quality effects.
Elements of originality of the work
The paper provides the first systematic evidence on the system-wide spillovers of hospital department downsizing in Italy using granular ward-level data. It documents sizable patient reallocation effects and highlights important trade-offs between increased activity and rising congestion and mortality. The analysis uncovers strong heterogeneity by hospital ownership and geography, showing that public hospitals absorb most of the displaced demand, while private providers adjust selectively, and that downsizing exacerbates patient outflows in the South. These findings offer new insights into the unintended access and quality costs of hospital consolidation policies and underscore the importance of coordinated capacity planning.

Mr Aidan Araujo (p), Prof. André Chagas

Urban mobility is a fundamental component of the daily life in cities, considering it guarantees access to health services, employment, education and leisure. Free-Fare on Public Transport (FFPT), a policy that aims to make the public transport economically more accessible, has been implemented around the world to deal with the mobility issue. The outcomes of this policy remain a subject of ongoing scholarly debate, considering it impacts different areas, such as health, labor, and environment. Existing research in this field is largely situated within the context of understanding FFPT’s influence on travel mode selection. This research contributes to the debate on FFPT's effects on mode choice by focusing on a high-density environment. It investigates the city of São Caetano do Sul (SCS), in the Metropolitan Region of São Paulo, Brazil, which involves a small, but dense area. The FFPT in this city was implemented during the household survey “Origin-Destination Metro” data collection period, in 2023, and this is the main important database for the research. It also uses General Transit Feed Specification (GTFS) files to estimate the commuters’ paths by public transport. Using a discrete choice model, the research estimates the impact of this policy in the commuter’s mode choice. The study focuses on travels related to work and study and in the modes of car, public transport, motorcycle, and walk. Public transport includes an integrated network of subway, rail, different cities municipal bus and intermunicipal bus. Results indicate that the main important changes after the FFPT were a rise in public transport travels due to a decrease in motorcycle and car travels. Among different socioeconomic classes, low-income groups were the most benefited by this policy. Moreover, women and non-white people were proportionately more impacted than men and white ones. The findings suggest that FFPT can be an effective instrument not only for achieving modal shift but also for advancing urban equity in metropolitan areas.

Dr. Yadira Gomez-Hernandez (p), Gonzalo Nunez-Chaim, Prof Henry Overman

This paper evaluates the economic impacts of local public transport schemes - small additions to the transport network - focusing on effects on the number of businesses, employment, turnover, productivity, and house prices. Using granular data from 1997 to 2019 and quasi experimental methods, we provide new evidence on the local economic consequences of these interventions. Our preliminary results show that although the number of businesses increases, there is no effect on total employment, and we observe a negative effect in median turnover and a small reduction in median employment. These patterns are consistent with a shift in the composition of firms: the number of micro businesses (fewer than 10 employees) rises, and because such firms typically generate lower turnover, this helps explain the observed declines in other outcomes. The impacts also appear highly localised, with no evidence of effects beyond 0.5 km. In the next stage of the analysis, we will explore these mechanisms in more detail and examine whether impacts differ by type of transport scheme (trams, buses, and accessibility projects).