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The nature of surgeon human capital depreciation

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  • Hockenberry, Jason M.
  • Helmchen, Lorens A.

Abstract

To test how practice interruptions affect worker productivity, we estimate how temporal breaks affect surgeons’ performance of coronary artery bypass grafting (CABG). Examining 188 surgeons who performed 56,315 CABG surgeries in Pennsylvania between 2006 and 2010, we find that a surgeon's additional day away from the operating room raised patients’ inpatient mortality by up to 0.067 percentage points (2.4% relative effect) but reduced total hospitalization costs by up to 0.59 percentage points. Among emergent patients treated by high-volume providers, where temporal distance is most plausibly exogenous, an additional day away raised mortality risk by 0.398 percentage points (11.4% relative effect) but reduced cost by up to 1.4 percentage points. This is consistent with the hypothesis that as temporal distance increases, surgeons are less likely to recognize and address life-threatening complications. Our estimates imply additional intraprocedural treatment intensity has a cost per life-year preserved of $7871–18,500, well within conventional cost-effectiveness cutoffs.

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  • Hockenberry, Jason M. & Helmchen, Lorens A., 2014. "The nature of surgeon human capital depreciation," Journal of Health Economics, Elsevier, vol. 37(C), pages 70-80.
    • Handle: RePEc:eee:jhecon:v:37:y:2014:i:c:p:70-80
    DOI: 10.1016/j.jhealeco.2014.06.001
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    Cited by:

    1. Gabriel Facchini, 2022. "Forgetting‐by‐not‐doing: The case of surgeons and cesarean sections," Health Economics, John Wiley & Sons, Ltd., vol. 31(3), pages 481-495, March.
    2. Ortego-Marti, Victor, 2017. "Differences in skill loss during unemployment across industries and occupations," Economics Letters, Elsevier, vol. 161(C), pages 31-33.
    3. Ortego-Marti, Victor, 2017. "Loss of skill during unemployment and TFP differences across countries," European Economic Review, Elsevier, vol. 100(C), pages 215-235.
    4. Raf Van Gestel & Tobias Müller & Johan Bosmans, 2018. "Learning from failure in healthcare: Dynamic panel evidence of a physician shock effect," Health Economics, John Wiley & Sons, Ltd., vol. 27(9), pages 1340-1353, September.
    5. Rachet-Jacquet, Laurie, 2022. "Do breaks from surgery improve the performance of orthopaedic surgeons?," Journal of Health Economics, Elsevier, vol. 85(C).
    6. Paul Jackson & Victor Ortego-Marti, 2020. "Skill Loss during Unemployment and the Scarring Effects of the COVID-19 Pandemic," Working Papers 202020, University of California at Riverside, Department of Economics.
    7. Rachet-Jacquet, Laurie & Gutacker, Nils & Siciliani, Luigi, 2021. "Scale economies in the health sector: The effect of hospital volume on health gains from hip replacement surgery," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 704-729.
    8. Raf Van Gestel & Tobias Müller & Johan Bosmans, 2017. "Does my high blood pressure improve your survival? Overall and subgroup learning curves in health," Health Economics, John Wiley & Sons, Ltd., vol. 26(9), pages 1094-1109, September.
    9. Lundborg, Petter & James, Stefan & Lagerqvist, Bo & Vikström, Johan, 2021. "Learning-by-Doing and Productivity Growth among High-Skilled Workers: Evidence from the Treatment of Heart Attacks," IZA Discussion Papers 14744, Institute of Labor Economics (IZA).
    10. Kuhn, Michael A. & Kuhn, Peter & Villeval, Marie Claire, 2017. "Decision-environment effects on intertemporal financial choices: How relevant are resource-depletion models?," Journal of Economic Behavior & Organization, Elsevier, vol. 137(C), pages 72-89.
    11. Raf Van Gestel & Tobias Mueller & Johan Bosmans, 2018. "Learning from failure in healthcare: Dynamic panel evidence of a physician shock effect," Diskussionsschriften dp1809, Universitaet Bern, Departement Volkswirtschaft.
    12. Steven Salaga & Brian M. Mills & Scott Tainsky, 2020. "Employer-Assigned Workload and Human Capital Deterioration: Evidence From the National Football League," Journal of Sports Economics, , vol. 21(6), pages 628-659, August.
    13. Van Gestel, R.; Müller, T.; Bosmans, J.;, 2017. "Learning from failure in healthcare: dynamic panel evidence of a physician shock effect," Health, Econometrics and Data Group (HEDG) Working Papers 17/24, HEDG, c/o Department of Economics, University of York.

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    More about this item

    Keywords

    Human capital; Productivity; Skill depreciation; Returns to medical spending;
    All these keywords.

    JEL classification:

    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • I10 - Health, Education, and Welfare - - Health - - - General

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