Journal of Health Economics · 2026 · Qing Chang、Ke Tang、Danxia Xie、Longtian Zhang
中文摘要
我们研究大流行期间个体的迁移决策如何与医疗资源的空间配置相互作用,并以闭式解刻画了自由放任均衡与计划者配置。易感个体离开感染率高的城市,而感染个体则流向医疗资源更充裕的城市,但这些私人决策在两个维度上与计划者的选择存在偏离。其一,感染个体向易感者密集目的地的迁移提高了传播风险,这是一种传染外部性,计划者通过限制此类流动将其内部化。其二,感染个体向医疗资源更充裕城市的迁移缓解了疫情震中医院的拥挤,这是一种拥挤外部性,计划者通过鼓励此类流动将其内部化。这两种外部性的作用方向相反,我们的比较静态分析表明了各自在何时占主导。该框架解释了一个标准错配理论无法解释的跨国模式:新冠疫情期间,死亡率区域离散程度较高的国家往往总体死亡率较低。一旦在标准错配框架中加入传染与内生流动性,这一模式便自然出现。更广泛地看,该分析识别出一类空间分散能够提高而非降低福利的情形,从而逆转了标准错配政策处方的符号。
Abstract
We study how individuals’ migration decisions during a pandemic interact with the spatial allocation of hospital resources, characterizing both the laissez-faire equilibrium and the planner’s allocation in closed form. Susceptible individuals leave high-infection cities while infected individuals move toward better-resourced ones, but these private decisions diverge from the planner’s along two dimensions. First, the migration of infected agents toward susceptible-rich destinations raises transmission risk, a contagion externality the planner internalizes by restricting such flows. Second, the migration of infected agents toward better-resourced cities relieves hospital congestion at the epicenter, a congestion externality the planner internalizes by encouraging such flows. The two externalities work in opposite directions, and our comparative statics show when each dominates. The framework explains a cross-country pattern that standard misallocation theory cannot: during COVID-19, countries with greater regional dispersion in mortality tended to have lower aggregate mortality. This pattern arises naturally once contagion and endogenous mobility are added to a standard misallocation framework. More broadly, the analysis identifies a setting in which spatial dispersion can raise rather than reduce welfare, reversing the sign of the standard misallocation prescription.