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Estimating returns to hospital volume: Evidence from advanced cancer surgery
Univ Duisburg Essen, Duisburg, Germany;CINCH Essen, Essen, Germany.
Lund Univ, Dept Econ, Lund, Sweden;IZA Bonn, Bonn, Germany.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Economics. Uppsala University, Units outside the University, Office of Labour Market Policy Evaluation.
2019 (English)In: Journal of Health Economics, ISSN 0167-6296, E-ISSN 1879-1646, Vol. 63, p. 81-99Article in journal (Refereed) Published
Abstract [en]

High-volume hospitals typically perform better than low-volume hospitals. In this paper, we study whether such patterns reflect a causal effect of case volume on patient outcomes. To this end, we exploit closures and openings of entire cancer clinics in Swedish hospitals which provides sharp and arguably exogenous variation in case volumes. Using detailed register data on more than 100,000 treatment episodes of advanced cancer surgery, our results suggest substantial positive effects of operation volume on survival. Complementary analyses point to learning-by-doing as an important explanation. (C) 2018 Elsevier B.V. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 63, p. 81-99
Keywords [en]
Hospital case volume, Learning-by-doing, Cancer surgery, Survival, Causal effect
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:uu:diva-379774DOI: 10.1016/j.jhealeco.2018.10.005ISI: 000460716100006PubMedID: 30529091OAI: oai:DiVA.org:uu-379774DiVA, id: diva2:1297987
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, DNR 2004-2005Forte, Swedish Research Council for Health, Working Life and Welfare, 2009-0826The Jan Wallander and Tom Hedelius FoundationAvailable from: 2019-03-21 Created: 2019-03-21 Last updated: 2019-03-21Bibliographically approved

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Vikström, Johan

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