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Jonathan Skinner, Dartmouth University

March 4, 2020 @ 12:00 pm - 1:30 pm PST

Hospital Productivity and the Misallocation of Healthcare Inputs

Abstract: There is growing evidence for wide variation in total factor productivity across hospitals, with large differences in risk-adjusted health outcomes as well as expenditures. In this paper, we consider the additional contribution of misallocation in input choices – the underuse of effective inputs and overuse of ineffective ones — to explain why some hospitals get better outcomes at lower cost. The sample is of 1.7 million patients in the Medicare fee-for-service population with acute myocardial infarction (AMI), or heart attacks, during 2007-17.  The problem of confounding health factors is addressed in several ways, including the use of tourists, whose assignment to hospitals resembles random assignment (Doyle, 2011), and ZIP-code fixed effects.  Briefly, we find strong evidence for input misallocation across hospitals; greater use of highly effective inputs, such as beta blocker, statin, and ACE/ARB drug treatments, primary care support, and stenting are predictive of highly-productive hospitals, while an excess of multiple physicians, scans, and potentially fraudulent excess home health care billings are predictive of low-productivity hospitals.

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Details

Date:
March 4, 2020
Time:
12:00 pm - 1:30 pm
Event Categories:
,

Venue

4240 Public Affairs Bldg

Organizer

California Center for Population Research

Details

Date:
March 4, 2020
Time:
12:00 pm - 1:30 pm
Event Categories:
,

Venue

4240 Public Affairs Bldg

Organizer

California Center for Population Research