Thomas P. Hoe
I am an Assistant Professor at Cornell University in the Department for Policy Analysis and Management (PAM) and a Research Associate at the Institute for Fiscal Studies in London.
My research combines large-scale administrative data with techniques from applied microeconomics and statistics to study policy questions in health care industries. In recent work I have evaluated how patient health outcomes and wait times are affected by emergency department regulations and inpatient department crowding.
Prior to working in academia, I managed microeconomic and econometric studies for the UK government and a private sector consultancy in London. I ran projects across a range of industries including retail, transport, technology, financial services, health care, and energy.
Download CV | Email: tomphoe@gmail.com
WORKING PAPERS
'Does Hospital Crowding Matter? Evidence from Trauma and Orthopedics in England', Accepted at American Economic Journal: Economic Policy
Abstract: This paper estimates and documents the impact of hospital crowding on medical treatment decisions and patient health outcomes. Exploiting pseudo-random variation in emergency admits, I find that a one standard deviation admission shock increases the unplanned readmission rate by 4.1%. Non-parametric and heterogeneity analyses indicate these effects are caused by quicker and sicker discharges due to bed constraints. The crowding impacts are larger at hospital departments with relatively few beds, higher severity patients, and stronger incentives to admit non-emergency patients.
'Saving Lives by Tying Hands: The Unexpected Effects of Constraining Health Care Providers' with Jonathan Gruber (MIT) and George Stoye (UCL), Accepted at Review of Economics and Statistics
Abstract: The emergency department (ED) is a complex node of healthcare delivery that is facing market and regulatory pressure across developed economies to reduce wait times. In this paper we study how ED doctors respond to such incentives, by focussing on a landmark policy in England that imposed strong incentives to treat ED patients within four hours. Using bunching techniques, we estimate that the policy reduced affected patients' wait times by 19 minutes, yet distorted a number of medical decisions. In response to the policy, doctors increased the intensity of ED treatment and admitted more patients for costly inpatient care. We also find a striking 14% reduction in mortality. To determine the mechanism behind these health improvements, we exploit heterogeneity in patient severity and hospital crowding, and find strongly suggestive evidence that it is the reduced wait times, rather than the additional admits, that saves lives. Overall we conclude that, despite distorting medical decisions, constraining ED doctors can induce cost-effective reductions in mortality.
WORK IN PROGRESS
'Killer Deals? The Impact of Hospital Mergers on Clinical Quality' with Elena Ashtari Tafti (UCL)