Does Research Save Lives? The Local Spillovers of Biomedical Research on Mortality" with Bruce A. Weinberg
NBER working paper No. 29420.
Abstract: This paper investigates the local impact of biomedical research on mortality in the USA. Causally estimating the marginal value of biomedical research is challenging due to a lack of micro data linking health outcomes to plausibly exogenous variation in research. We create a new linkage between a research database (PubMed) and administrative death records that enables research to be related to mortality at the geographic, disease and time level. We then estimate the marginal impact of biomedical research on mortality using hospital market (HRR) level shocks to research activity by disease. Our identification strategy builds on the literature on the dissemination of knowledge, specifically that of local knowledge spillovers. By utilizing variation across diseases, time and distance from research we control for additional trends relative to the current literature. Our results show that an additional research publication on average reduces local mortality from a disease by 0.35%. Our results also provide novel evidence that there are health benefits to the local communities (local spillovers) in which biomedical research is conducted.
"Medical Practice Closures and Inequality in Healthcare Utilization" with Xuechao Qian (revisions requested at American Journal of Health Economics
Abstract: This paper studies the effect of the closure of office-based medical practices on the location where patients sought healthcare during the first year of the COVID-19 pandemic. First we show that the exit rate of office-based practices increased in 2020 using data from a nationwide US claims database. Using this supply shock to patients, we then show that following an office-based practice closure, there is an increase in overall usage of emergency departments. There is also a shift from office-based care to hospital-based care, suggesting that some patients are not able to establish a new relationship with an office-based provider within five months of the practice closure. Patients from areas with greater disadvantage (lower income levels and higher shares of minority population) as well as the elderly and Medicaid beneficiaries are disproportionately affected. However, the availability of telehealth services mitigates the impact.