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Capacity and Utilization in Health Care: The Effect of Empty Beds on Neonatal Intensive Care Admission

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  • Seth Freedman

Abstract

Because geographic variation in medical care utilization is jointly determined by both supply and demand, it is difficult to empirically estimate whether capacity itself has a causal impact on utilization in health care. In this paper, I exploit short-term variation in Neonatal Intensive Care Unit (NICU) capacity that is unlikely to be correlated with unobserved demand determinants. I find that available NICU beds have little to no effect on NICU utilization for the sickest infants, but do increase utilization for those in the range of birth weights where admission decisions are likely to be more discretionary. (JEL I11, I12, I18, J13)

Suggested Citation

  • Seth Freedman, 2016. "Capacity and Utilization in Health Care: The Effect of Empty Beds on Neonatal Intensive Care Admission," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 154-185, May.
    • Handle: RePEc:aea:aejpol:v:8:y:2016:i:2:p:154-85
    Note: DOI: 10.1257/pol.20120393
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    Citations

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    Cited by:

    1. Simon Bensnes, 2021. "Time to spare and too much care. Congestion and overtreatment at the maternity ward," Discussion Papers 963, Statistics Norway, Research Department.
    2. Martin B. Hackmann & R. Vincent Pohl & Nicolas R. Ziebarth, 2018. "Patient Versus Provider Incentives in Long Term Care," NBER Working Papers 25178, National Bureau of Economic Research, Inc.
    3. Jürges, Hendrik & Köberlein, Juliane, 2015. "What explains DRG upcoding in neonatology? The roles of financial incentives and infant health," Journal of Health Economics, Elsevier, vol. 43(C), pages 13-26.
    4. Facchini, Gabriel, 2022. "Low staffing in the maternity ward: Keep calm and call the surgeon," Journal of Economic Behavior & Organization, Elsevier, vol. 197(C), pages 370-394.
    5. Jürges, Hendrik & Köberlein, Juliane, 2013. "First do no harm. Then do not cheat: DRG upcoding in German neonatology," MEA discussion paper series 201307, Munich Center for the Economics of Aging (MEA) at the Max Planck Institute for Social Law and Social Policy.
    6. Freedman, Seth & Lin, Haizhen & Simon, Kosali, 2015. "Public health insurance expansions and hospital technology adoption," Journal of Public Economics, Elsevier, vol. 121(C), pages 117-131.
    7. Kevin Callison & Robert Kaestner & Jason Ward, 2018. "A Test of Supply-side Explanations of Geographic Variation in Health Care Use," NBER Working Papers 25037, National Bureau of Economic Research, Inc.
    8. Yayun Ren & Jian Yu & Shuhua Xu & Jiaomei Tang & Chang Zhang, 2023. "Green Finance and Industrial Low-Carbon Transition: Evidence from a Quasi-Natural Experiment in China," Sustainability, MDPI, vol. 15(6), pages 1-17, March.
    9. Mindy Marks & Kate Choi, 2011. "Baby Boomlets and Baby Health: Hospital Crowdedness, Treatment Intensity, and Infant Health," Working Papers 201440, University of California at Riverside, Department of Economics.
    10. Janet Currie & David Slusky, 2020. "Does the Marginal Hospitalization Save Lives? The Case of Respiratory Admissions for the Elderly," NBER Working Papers 26618, National Bureau of Economic Research, Inc.
    11. Lee, Ajin, 2020. "How do hospitals respond to managed care? Evidence from at-risk newborns," Journal of Public Economics, Elsevier, vol. 184(C).
    12. Kleiner, Samuel A., 2019. "Hospital treatment and patient outcomes: Evidence from capacity constraints," Journal of Public Economics, Elsevier, vol. 175(C), pages 94-118.
    13. Marc Beltempo & Georges Bresson & Jean-Michel Étienne & Guy Lacroix, 2022. "Infections, accidents and nursing overtime in a neonatal intensive care unit," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(4), pages 627-643, June.
    14. Freedman, Seth & Golberstein, Ezra & Huang, Tsan-Yao & Satin, David J. & Smith, Laura Barrie, 2021. "Docs with their eyes on the clock? The effect of time pressures on primary care productivity," Journal of Health Economics, Elsevier, vol. 77(C).
    15. Emilio Gutierrez & Adrian Rubli, 2021. "Shocks to Hospital Occupancy and Mortality: Evidence from the 2009 H1N1 Pandemic," Management Science, INFORMS, vol. 67(9), pages 5943-5952, September.
    16. André Madeira & Victor Moutinho & José Alberto Fuinhas, 2021. "Does waiting times decrease or increase operational costs in short and long-term? Evidence from Portuguese public hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(8), pages 1195-1216, November.
    17. Mindy Marks & Moonkyung Kate Choi, 2019. "Baby Boomlets and Baby Health: Hospital Crowdedness, Hospital Spending, and Infant Health," American Journal of Health Economics, MIT Press, vol. 5(3), pages 376-406, Summer.
    18. Maibom, Jonas & Sievertsen, Hans H. & Simonsen, Marianne & Wüst, Miriam, 2021. "Maternity ward crowding, procedure use, and child health," Journal of Health Economics, Elsevier, vol. 75(C).

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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