Research

Working papers


We use data on a large wave of directed hospital mergers and closures in Ontario to investigate the impact of hospital reorganization on patient welfare. We estimate a model of patient hospital choice on data collected before the reorganization, finding that both distance and hospital quality are determinants of choice. The model is then used to simulate the short-run and long-run welfare impact of reorganization. Results suggest that cost savings and efficiency are not the only factors to consider when restructuring in settings where patients do not pay for services. Hospital access and quality must be considered.


We investigate the market for senior management in the U.S. charities sector. Using charity-level data from 990 Forms filed for U.S. Internal Revenue Service, we document two new stylized facts not documented before in the literature. First, we find that female managers are more likely to receive compensation than male managers. Second, conditional on receiving compensation, female managers receive 8% lower total compensation than male managers. We show the gender pay gap is only present in the largest charities (top two quintiles in the revenue distribution). Both findings are robust to the inclusion of charity classification fixed effects (between estimator) and charity fixed effects (within estimator). Our exploration of mechanisms driving the gender pay gap in this context points out a mismatch between pay dispersion and performance dispersion. While pay dispersion across genders is consistent with organizations perceiving male managers as differentiated unlike female managers, and there are no differences in performance dispersion supporting this perception.


Hospitals in public and private healthcare systems frequently undergo mergers, despite mixed evidence on their effects on quality and cost. We use confidential health data from Ontario to evaluate the effect of hospital mergers on measures of hospital quality, efficiency and capacity. In particular, we investigate the claim that hospital mergers involving physical restructuring are more likely to improve these measures than hospital mergers that are administrative in nature. Our primary analysis demonstrates that for most outcomes, hospital restructuring does not have an impact. We find evidence of a relative temporary decrease in occupancy and an increase in total beds and alternate-level-of-care days at merged hospitals with mitigated effects when site closures are involved. We do not find evidence that mergers of either type significantly improve financial performance, but merged hospitals that do not physically restructure experience better financial performance than those that physically restructure. 


Work in progress


Non-refereed publications


Email: ebarker@hamilton.edu