Supply-side variation in the use of emergency departments

Zeltzer, Dan; Einav, Liran; Chasid, Avichai; Balicer, Ran D.

doi:10.1016/j.jhealeco.2021.102453

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…Urgent care centers in particular are a close substitute. Some studies find that they siphon‐off low acuity patients 29–32 . Wang et al 20 find that the degree of substitution is small: there is one less low acuity emergency department visit for every 37 urgent care center visits.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies find that they siphon-off low acuity patients. [29][30][31][32] Wang et al 20 find that the degree of substitution is small: there is one less low acuity emergency department visit for every 37 urgent care center visits. Xu and Ho 33 find that the entry of freestanding emergency departments does not affect the number of visits to hospital-based departments.…”

Section: Discussionmentioning

confidence: 99%

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Hospital ownership and admission rates from the emergency department, evidence from Florida

Howard,

David

2023

Health Services Research

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ObjectiveIn light of Department of Justice investigations of for‐profit chains for over‐admitting patients, we sought to evaluate whether for‐profit hospitals are more likely to admit patients from the emergency department.Data SourcesWe used statewide visit‐level inpatient and emergency department records from Florida's Agency for Healthcare Administration for 2007–2019.Study DesignWe calculated differences in admission rates between for‐profit and other hospitals, adjusting for patient and hospital characteristics. We also estimated instrumental variables models using differential distance to a for‐profit hospital as an instrument.Data Collection/Extraction MethodsOur main analysis focuses on patients ages 65 and older treated in hospitals that primarily serve adults.Principal FindingsAdjusted admission rates among patients ages 65 and older were 7.1 percentage points (95% CI: 5.1–9.1) higher at for‐profit hospitals in 2019 (or 18.8% of the sample mean of 37.8%). Differences in admission rates have remained constant since 2009.ConclusionOur results are consistent with allegations that for‐profit hospitals maintain lower admission thresholds to increase occupancy levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hospital ownership and admission rates from the emergency department, evidence from Florida

Howard,

David

2023

Health Services Research

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“…A number of recent studies on regional variation have used regional migration data to try to separate demand and supply factors (Godøy & Huitfeldt, 2020;Molitor, 2018;Moura et al, 2019;Salm & Wübker, 2020;Song et al, 2010;Zeltzer et al, 2021). The general idea in this approach is that if place-specific institutional features (supply) are most important, we expect regional migrants to change health care utilization behavior when moving into a new region (Finkelstein et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Regional variation in prescription drug spending: Evidence from regional migrants in Sweden

Johansson

Svensson

2022

Health Economics

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There is substantial variation in drug spending across regions in Sweden, which can be justified if caused by differences in health need, but an indication of inefficiencies if primarily caused by differences in place-specific supply-side factors.This paper aims to estimate the relative effect of individual demand-side factors and place-specific supply-side factors as drivers of geographical variation in drug spending in Sweden. We use individual-level register data on purchases of prescription drugs matched with demographic and socioeconomic data of a random sample of about 900,000 individuals over 2007-2016. The primary empirical approach is a two-way fixed effect model and an event study where we identify demand-and supply-side effects based on how regional and local migrants change drug spending when moving across regional and municipal borders. As an alternative approach in robustness checks, we also use a decomposition analysis. The results show that the place-specific supply-side effect accounts for only about 5%-10% of variation in drug spending and remaining variation is due to individual demand-side effects.These results imply that health policies to reduce regional variation in drug spending would have limited impact if targeted at place-specific characteristics.

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“…For example, see other research on the determinants of health care that exploits moves among individuals(Agha, Frandsen and Rebitzer, 2019; Godøy and Huitfeldt, 2020; Finkelstein et al, 2022; Ding, 2022;Zeltzer et al, 2021) and physicians(Molitor, 2018;Beheshti and Neller, 2021; Doyle and Staiger, 2021).6 The confidence intervals are virtually unchanged when using two-way clustering on origin and destination county instead of clustering at the individual level.…”

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confidence: 99%

Partial Outsourcing of Public Programs: Evidence on Determinants of Choice in Medicare

Cabral¹,

Carey²,

Son³

2023

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Supply-side variation in the use of emergency departments

Cited by 5 publications

References 15 publications

Hospital ownership and admission rates from the emergency department, evidence from Florida

Hospital ownership and admission rates from the emergency department, evidence from Florida

Regional variation in prescription drug spending: Evidence from regional migrants in Sweden

Partial Outsourcing of Public Programs: Evidence on Determinants of Choice in Medicare

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