Publications
American Economic Review, December 2021; 111(12): 3923-3962.
Coverage: Econimate; The Visible Hand
Abstract: This paper studies whether team members' past collaboration creates team-specific human capital and influences current team performance. Using administrative Medicare claims for two heart procedures, I find that shared work experience between the doctor who performs the procedure ("proceduralist") and the doctors who provide care to the patient during the hospital stay for the procedure ("physicians") reduces patient mortality rates. A one standard deviation increase in proceduralist-physician shared work experience leads to a 10-14 percent reduction in patient 30-day mortality. Patient medical resource use also declines with shared work experience, even as survival improves.
The Roots of Health Inequality and the Value of Intra-Family Expertise (with Petra Persson and Maria Polyakova)
American Economic Journal: Applied Economics, July 2022; 14(3): 185-223.
Coverage: BBC; NBER Digest; VoxEU; UN Human Development Report 2019; Futurity; Scope Blog; Medical Xpress; Becker's Hospital Review; KCBS Radio; SIEPR News; Dagens Nyheter (in Norwegian); Sueddeutsche Zeitung (in German); Stanford Health Policy; Freakonomics, M.D.
Abstract: In the context of Sweden, we show that having a doctor in the family raises preventive health investments throughout the lifecycle, improves physical health, and prolongs life. Two quasi-experimental research designs -- medical school admissions lotteries and variation in the timing of medical degrees -- support a causal interpretation of these effects. A hypothetical policy that would bring the same health behavior changes and benefits to all Swedes would close 18 percent of the mortality-income gradient. Our results suggest that socioeconomic differences in exposure to health-related expertise may meaningfully contribute to health inequality.
Working Papers
Revised and resubmitted, American Economic Review
Coverage: Kaiser Health News; CNN; NPR; Vox; Brookings; Bloomberg; Freakonomics, M.D.; NBER Featured Working Papers; MedPageToday; Becker's Hospital Review
NBER working paper #30608
Abstract: This paper studies the productivity of nurse practitioners (NPs) and physicians, two professions performing overlapping tasks but with starkly different backgrounds, training, and pay. Using quasi-experimental variation in patient assignment to NPs versus physicians in Veterans Health Administration emergency departments, we find that, on average, NPs use more resources and exhibit a higher 30-day preventable hospitalization rate than physicians. However, the NP-physician performance difference varies by case complexity and severity. Importantly, even larger productivity variation exists within each profession, leading to substantial overlap between the productivity distributions of the two professions; NPs outperform physicians in 38 percent of random pairs.
Government Monitoring of Health Care Quality: Evidence from the Nursing Home Sector (with Marcus Dillender)
NBER working paper #34037
In contracting out, monitoring is an important policy tool to extract information on firm quality and incentivize quality provision. This paper examines a central quality inspection of nursing homes, a sector with significant welfare implications but widespread public concerns about the quality of care. Using data on nursing homes across the US, we find that nursing homes exhibit strategic responses to the inspection. Nursing homes increase the quantity and quality of labor inputs, reduce admissions, increase temporary discharges, and improve patient care in response to the inspection. However, nearly all responses drop immediately once the inspection is completed. While inspection ratings are unlikely to reflect nursing homes' absolute quality given the strategic responses, using a quasi-experimental research design we find that inspection ratings predict nursing homes' relative quality. Finally, we examine the effects of quality deficiency citations issued by the inspection on incentivizing nursing homes to improve quality of care, finding mixed impacts.
Selected Work in Progress
The Productivity of the Intensive Care Unit (with David Chan)
Provider Diversity and Health Disparities (with Alex Chan and Cameron Deal)