Evidence from Internet-Search Behavior in 11 Countries* * *We are grateful to Sonia Bhalotra and Renata Cuk for helpful discussion. We thank Alejo Isacch and Julián Pedrazzi for excellent research assistance. Facchini gratefully acknowledges financial support from the General Secretariat for Research-Government of Catalonia (SGR2017-1301) and the Spanish Ministry of Education (PID2019-104619RB-C43). Views expressed here do not necessarily correspond to those of our affiliations.
We study the long-term effects of intergroup contact on nation building by exploiting a national lottery that randomly allocated conscripts to different military areas across Spain. For men born in regions featuring a strong regional identity, we find that being assigned to military service in a region different from one's region of birth substantially increases self-identification as Spanish and reduces the likelihood of voting for a regionalist party. Moreover, in support of intergroup contact as the main mechanism behind these results, we find that movers are more likely to have friends from another region than nonmovers.
Since the seminal report by (Luft et al., 1979), there has been growing evidence of a positive association between volume and quality in the provision of health services for a wide variety of procedures, time periods, and locations. 1 Nevertheless, the debate about the causal direction of this relationship is far from settled (Halm et al., 2002;Ho, 2014).Two principal hypothesis have been put forward to explain this association: (i) "learning-by-doing" (or "practice-makes-perfect") and (ii) "selective referral" (Luft et al., 1987). 2 Under "learning-by-doing," increased experience leads to improvement in skills which in turn results in better quality as measured by patient outcomes. "Selective referral," instead, occurs when providers with higher quality attract a larger volume of patients. The importance of identifying which one is driving the correlation between volume and outcome stems from the fact that they have opposite policy implications. If volume causes outcome, as learning-by-doing suggests, then the concentration of procedures in fewer and bigger providers would raise quality. However, if causality runs from outcome to volume, then those benefits are not present anymore, and concentration would only lead to reduced competition between providers and lower geographical coverage.
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