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CINCH - Health Economics Research Center

New CINCH Working Paper


A new working paper has been added to the CINCH working paper series: “Providers, Peers and Patients: How do Physicians’ Practice Environments Affect Patient Outcomes?” by Daniel Avdic, Maryna Ivets, Bo Lagerqvist, and Ieva Sriubaite.

Abstract: We study the extent to which physician treatment styles are determined by their practice environment and whether such decisions affect the quality of care received by patients. Using rich data on all coronary angioplasty procedures in Sweden 2004–2013, our empirical approach compares stent choices of interventional cardiologists moving across hospitals to patient outcomes over time. To disentangle changes in practice styles attributable to physical (provider) and social (peer group) factors, we exploit quasi‐random variation on physicians working on the same day in the same hospital. Our findings suggest that (i) moving cardiologists’ stent choices rapidly adapt to their new practice environment after relocation; (ii) practice style changes are equally driven by the physical and social environments; and (iii) rates of decision errors, treatment costs and adverse clinical events among treated patients remain largely unchanged despite the altered practice styles.

See all working papers.

Virtual Essen Health Economics Seminar


On Monday, February 8 2021, 16:00 - 17:30, Frank Schilbach (MIT) will present:

The Economic Consequences of Increasing Sleep Among the Urban Poor

Using state-of-the-art technology, we document that adults in Chennai sleep only 5.5 hours per night on average despite spending 8 hours in bed. Their sleep is highly interrupted, with sleep efficiency—sleep per time in bed—comparable to those with disorders such as sleep apnea or insomnia. A randomized three-week treatment providing information, encouragement, and improvements to home sleep environments increased sleep duration by 27 minutes per night but came at the cost of more time in bed. Contrary to expert predictions, increased night sleep had no detectable effects on cognition, productivity, decision-making or well-being, and led to small decreases in labor supply. Yet, increased sleep can have benefits in this setting: short afternoon naps at the workplace improved an overall index of outcomes by 0.12 standard deviations, with significant increases in productivity, psychologica lwell-being, and cognitive function, but less time available for work.

Room: Due to the current situation regarding the COVID-19 pandemic, the talk will be held in a virtual seminar room. For more information click here.

Virtual Essen Health Economics Seminar


On Monday, February 1 2021, 16:00 - 17:30, Eduardo Costa (Nova School of Business and Economics) will present:

License to Kill? The Impact of Hospital Strikes

Hospital strikes in the Portuguese National Health Service (NHS) are becoming increasingly frequent. This paper analyses the effect of different health professionals' strikes (physicians, nurses and diagnostic and therapeutic technicians - DTT) on patients’ outcomes and hospital activity. Patient-level data, comprising all NHS hospital admissions in mainland Portugal from 2012 to 2018, is used together with a comprehensive strike dataset with almost 130 protests. Pooled OLS is employed to study the impact of strikes on health outcomes. A Hazard model is also used to analyze changes in patients' length of stay. Data suggests that hospital operations are partially disrupted during strikes, with sharp reductions in surgical admissions (up to 54%) and a decline on both inpatient and outpatient care admissions. Controlling for hospital characteristics, time and regional patterns, and differences in patients’ composition, results suggest a 6% increase in hospital mortality for patients exposed to physicians’ strikes. Urgent readmissions increase for patients exposed to nurses or DTTs' strikes. Results suggest that legal minimum staffing levels defined during strikes, particularly during physicians' strikes, fail to prevent declines in the quality of care provided.

Room: Due to the current situation regarding the COVID-19 pandemic, the talk will be held in a virtual seminar room. For more information click here.