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Innovation Diffusion under Budget Constraints: Microeconometric Evidence on Heart Attack in France

In: Contributions in Memory of Zvi Griliches

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  • Brigitte Dormont
  • Carine Milcent

Abstract

We study the diffusion of innovative procedures for heart attack treatment, focusing on its impact on the distributions of the cost and length of hospital stays. We perform microsimulations on a sample of 5,681 stays in French public hospitals to evaluate the impacts of adoption of new techniques by hospitals, dissemination of new techniques within hospitals, and changes in patients' characteristics. Between 1994 and 1997, French public hospitals faced two main causes of rise in costs: diffusion of innovative procedures and a worsening of patients' state. However, they were financed by a global budget, and their budgets increased very slowly. We show that they deal with their financial constraints by reducing greatly the length of stays for patients at the bottom of the distribution. This appears to have enabled hospitals to finance the diffusion of angioplasty. Obviously, such a strategy cannot be sustained in the long run without jeopardizing the quality of care.

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This chapter was published in:

  • Jacques Mairesse & Manuel Trajtenberg, 2010. "Contributions in Memory of Zvi Griliches," NBER Books, National Bureau of Economic Research, Inc, number mair10-1, October.
    This item is provided by National Bureau of Economic Research, Inc in its series NBER Chapters with number 12251.

    Handle: RePEc:nbr:nberch:12251

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    1. DiNardo, John & Fortin, Nicole M & Lemieux, Thomas, 1996. "Labor Market Institutions and the Distribution of Wages, 1973-1992: A Semiparametric Approach," Econometrica, Econometric Society, vol. 64(5), pages 1001-44, September.
    2. Brigitte Dormont, 2003. "How to Regulate Heterogeneous Hospistals," THEMA Working Papers 2003-11, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
    3. Juhn, Chinhui & Murphy, Kevin M & Pierce, Brooks, 1993. "Wage Inequality and the Rise in Returns to Skill," Journal of Political Economy, University of Chicago Press, vol. 101(3), pages 410-42, June.
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    Cited by:
    1. Huber, Hélène & Grignon, Michel & Dormont, Brigitte, 2006. "Health expenditure growth : reassessing the threat of ageing," Economics Papers from University Paris Dauphine 123456789/3881, Paris Dauphine University.
    2. repec:hal:wpaper:halshs-00586837 is not listed on IDEAS
    3. Brigitte Dormont & Anne-Laure Samson, 2007. "Intergenerational inequalities in GPs' earnings : experience, time and cohort effects," Working Papers 0704, University of Lausanne, Institute of Health Economics and Management (IEMS).
    4. Laurent Gobillon & Carine Milcent, 2013. "Spatial disparities in hospital performance," Journal of Economic Geography, Oxford University Press, vol. 13(6), pages 1013-1040, November.
    5. Milcent, Carine & Dormont, Brigitte & Durand-Zaleski, Isabelle & Steg, Philippe Gabriel, 2007. "Gender differences in hospital mortality and use of percutaneous coronary intervention in acute myocardial infarction : microsimulation analysis of the 1999 nationwide french hospitals database," Economics Papers from University Paris Dauphine 123456789/5424, Paris Dauphine University.

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