Research
Working Papers
''Financial incentives and doctor labour supply: Evidence from a pension tax reform in England'' (with Carol Propper and Max Warner), IFS Working Paper W23/26, Sept 2023.
Abstract: We examine the labour supply response of senior doctors in England following a reform of the public sector pension system that moved employees from a final salary to a career average pension plan. Exploiting the staggered rollout of the reform across narrowly defined age groups, we find that doctors increased labour supply by just under 4% four years after exposure. This implies a labour supply elasticity with respect to pension wealth of -0.05, and with respect to current returns to work of 0.04. This indicates doctors’ responses were small despite relatively large changes in financial wealth induced by the reforms.
"The Distribution of Doctor Quality: Evidence from Cardiologists in England", IFS Working Paper W22/30, August 2022
Revisions requested at the Journal of Political Economy: Microeconomics
Abstract: There is widespread and unexplained variation in the outcome of similar patients across place and providers in all developed health systems. This paper provides new evidence on the role that senior doctors plays in determining patient outcomes. I exploit within-hospital quasi-random assignment of patients to senior doctors in England following a heart attack to estimate the effectiveness of individual physicians, and to estimate returns to experience for these doctors. 28% of doctors work in multiple hospitals for a 13-year period, enabling the separate identification of doctor effects from hospital effects or observable characteristics. I find that a one standard deviation increase in doctor quality reduces mortality rates over the next year by 3.6 percentage points, or 25% of mean mortality. There are relatively modest returns to specific experience, with mortality reductions from a one standard deviation increase in the physician's 3-year caseload equivalent to around 6% of a standard deviation in permanent doctor quality. Estimating the effectiveness of each physician when treating patients with specific diagnoses, I analyse potential mortality reductions from reallocating doctors across patients. I find that mortality could be reduced by 8% by reassigning doctors within-hospital to patients on the basis of their comparative ability to treat each patient type. These results suggest that substantial improvements in patient outcomes could be achieved by reallocating existing senior staff resources.
Work in progress
''How Redistributive is the English NHS?" (with Eric French, Jeremy McCauley and Ben Zaranko)
Peer-reviewed publications
“Dementia Incidence Trend in England and Wales 2002-2019 and Projection for Dementia Burden to 2020: English Longitudinal Study of Ageing” (with Yuntao Chen, Piotr Bandosz, Eric Brunner, Sophia Lobanov-Rostovsky, Jing Liao, Mika Kivimaki, Gill Livingston, Eric French, Yuyang Liu and Yanjuan Wu), The Lancet Public Health, 8(11):E859-E867, November 2023.
"The Effects of Doctor Strikes on Patient Outcomes: Evidence from the English NHS'' (with Max Warner), Journal of Economic Behavior and Organization, 212: 689-707, Aug 2023.
"Saving Lives By Tying Hands: The Unexpected Effects of Constraining Health Care Providers" (with Jonathan Gruber and Thomas P. Hoe), Review of Economics and Statistics, 105(1): 1-19, Jan 2023. Code | Policy summaries: Vox, IFS Observation. | Related media coverage: The Times, The Independent, The Mirror, NY Times.
"Socio-Economic Deprivation and Ethnicity Inequalities in Disruption to NHS Hospital Admissions during the COVID-19 Pandemic: A National Observational Study" (with Max Warner, Samantha Burn, Paul Aylin, Alex Bottle and Carol Propper), BMJ: Quality and Safety, 31:590-598. July 2022 | Policy summary: IFS Observation | Related media coverage: Medscape News | Wall Street Journal
'‘What will the cardiovascular disease slowdown cost? Modelling the impact of CVD trends on dementia, disability, and economic costs in England and Wales from 2020-2029.’' (with Brendan Collins, Piotr Bandosz, Maria Guzman-Castillo, Jonathan Pearson-Stuttard, Jeremy McCauley, Sara Ahmadi-Abhari, Marzieh Araghi, Martin J Shipley, Simon Capewell, Eric French, Eric J Brunner and Martin O’Flaherty), PLOS One, 17(6), June 2022.
''Long-term Care Spending and Hospital Use Among the Older Population in England" (with Rowena Crawford and Ben Zaranko), Journal of Health Economics, Vol 8, July 2021. Policy summary: IFS Observation | Related media coverage: The Independent, The Guardian.
"Educational Inequalities in Hospital Use Among Older Adults in England'' (with Ben Zaranko, Martin Shipley, Martin McKee and Eric Brunner), Milbank Quarterly, October 2020.
"The Impacts of Private Hospital Entry on the Public Market for Elective Care in England'' (with Elaine Kelly), Journal of Health Economics, Vol 73, September 2020.
"Medical Labour Supply and the Production of Healthcare" (with Tom Lee and Carol Propper), Fiscal Studies, Vol 4(40):621-661, February 2020.
"Cheaper, Greener and More Efficient: Rationalising UK Carbon Prices" (with Arun Advani), Fiscal Studies, Vol 38(2), June 2017.
"People or Places? Factors Associated with the Presence of Domestic Energy Efficiency Measures in England" (with Andrew Leicester), Fiscal Studies, Vol 38(2), June 2017.
"Public Hospital Spending in England: Evidence from National Health Service Administrative Records" (with Elaine Kelly and Marcos Vera-Hernández), Fiscal Studies , Vol 37 (3-4), November 2016.
"Challenges to Promoting Social Inclusion of the Extreme Poor: Evidence from a Large Scale Experiment in Colombia" (with Laura Abramovsky, Orazio Attanasio, Kai Barron and Pedro Carneiro), Economia - the LACEA Journal, Vol 16(2), pp 89-141, April 2016.
Requested (Non peer-reviewed) journal publications
“The Wider Impacts of the Coronavirus Pandemic on the NHS” (with Carol Propper and Ben Zaranko), Fiscal Studies, Vol 41, June 2020.
"The Outlook for Public Spending on the NHS" (with Rowena Crawford), Lancet, Vol 385, No 9974, pp 1155-1156, March 2015.