Juan M. Contreras () (Congressional Budget Office) Beomsoo Kim () (Department of Economics, Korea University, Seoul, South Korea) Ignez M. Tristao () (Congressional Budget Office)
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In this paper, we examine the ¡°learning-by-doing¡± hypothesis in medicine using a longitudinal census of laser in situ keratomileusis (LASIK) eye surgeries collected directly from patient charts. LASIK surgery has precise measures of presurgical condition and postsurgical outcomes. Unlike other types of surgery, the impact of unobservable underlying patient conditions on outcomes is minimal. Individual learning-bydoing is identified through observations of surgical outcomes over time based on the cumulative number of surgeries each surgeon has performed. Collective learning is identified separately through changes in a group adjustment rule determined jointly by all the surgeons through a structured internal review process. Our unique data set overcomes some of the measurement problems in patient outcomes encountered in other studies, and improves the possibility of identifying the impact of learning-by-doing separate from other effects. Our results do not support the hypothesis that the surgeon¡¯s individual learning improves outcomes, but we find strong evidence that experience accumulated by surgeons as a group in a clinic significantly improves outcomes.
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Paper provided by Institute of Economic Research, Korea University in its series Discussion Paper Series with number
0902.
Find related papers by JEL classification: I10 - Health, Education, and Welfare - - Health - - - General I12 - Health, Education, and Welfare - - Health - - - Health Production I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
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