When uber comes to town spatial frictions and health care access Ruochen Sun

Format:

Book

Thesis/Dissertation

Author/Creator:

Sun, Ruochen, author.

Contributor:

University of Pennsylvania. Applied Economics., degree granting institution.

Language:

English

Subjects (All):

Public policy.

Public health.

0501.

0769.

0630.

0573.

Local Subjects:

Public policy.

Public health.

0501.

0769.

0630.

0573.

Genre:

Academic theses

Physical Description:

1 online resource (106 pages)

Contained In:

Dissertations Abstracts International 87-12B

Place of Publication:

Ann Arbor : ProQuest Dissertations and Theses, 2026

Language Note:

English

Summary:

Health care is inherently local, and geographic distance and transportation constraints create spatial frictions that limit access to care. This paper examines how spatial frictions, which endogenously arise from the geographic sorting of both patients and providers, shape health care access and patient welfare. I first exploit Uber's staggered market entry in the U.S. as an exogenous shock to patient's travel cost in a difference-in-differences design. Using the universe of administrative claims data on Medicaid-enrolled children, I document two mechanisms through which travel costs shape health care access: how much care is consumed (market expansion effect) and which provider is chosen (substitution effect). Lower travel costs increase patients' use of primary care visits by 4.6%, which in turn improves key health inputs, such as vaccine adherence. It also changes where care is obtained and who provides it: patients travel 5.7% farther in driving time to new providers, increase visits to doctors in areas with poor public transit, and shift toward pediatric specialists over general practitioners. To quantify the welfare impact of spatial frictions, I next estimate a structural model of primary care provider choice with latent choice constraints that account for providers' heterogeneous willingness to accept Medicaid patients. I simulate counterfactual policies that reduce spatial frictions through two channels: 1) transportation subsidies that lower the cost per minute of travel and 2) increased provider payment that expands the network of willing providers, thereby reducing the distance patients must travel. The welfare gains from these policies are heterogeneous across neighborhoods: patients in low-income areas benefit from a combination of transportation subsidies and payment increases, whereas increasing provider payment alone is more effective in middle-income areas. These results suggest a place-based policy design to expand Medicaid access

Notes:

Source: Dissertations Abstracts International, Volume: 87-12, Section: B.

Advisors: Alpert, Abby; David, Guy Committee members: Alexander, Diane; Fang, Hanming; Handbury, Jessie

Ph.D. University of Pennsylvania 2026

Vendor supplied data

Local Notes:

School code: 0175

ISBN:

9798247979999

Access Restriction:

Restricted for use by site license