Empirical Economics

, Volume 42, Issue 2, pp 563–582 | Cite as

The effect of a law limiting upcoding on hospital admissions: evidence from Italy

  • Giorgio Vittadini
  • Paolo BertaEmail author
  • Gianmaria Martini
  • Giuditta Callea


Policy makers have made several attempts to limit hospitals’ upcoding. We investigate the impact of a law introducing a minimum length of stay for discharges with complications. We analyze its effects on the probability of a discharge with complications, on its length of stay and on its reimbursement. We show that the policy has been effective in limiting upcoding, since, after the law, (1) the probability of a discharge with complications has decreased by 3%; (2) its length of stay has risen by 0.17 days more than the observed corresponding variation in the length of stay of a discharge in the control group; (3) the hospital’s revenue on a discharge with complications has decreased by 8.5% more than the observed revenue change on a discharge in the control group. Furthermore, we find evidence of an ownership effect on upcoding, since not-for-profit and for-profit hospitals have been more affected by the law than public hospitals.


Upcoding Length of stay Logit model Difference-in-difference model 

JEL Classification

C51 I11 I18 L33 


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Giorgio Vittadini
    • 1
  • Paolo Berta
    • 1
    Email author
  • Gianmaria Martini
    • 2
  • Giuditta Callea
    • 2
  1. 1.Department of Quantitative MethodsCRISP, University of Milan BicoccaMilanItaly
  2. 2.Department of Economics and Technology ManagementUniversity of BergamoBergamoItaly

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