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Estimating returns to hospital volume: Evidence from advanced cancer surgery

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  • Avdic, Daniel
  • Lundborg, Petter
  • Vikström, Johan

Abstract

High-volume hospitals typically perform better than low-volume hospitals. In this paper, we study whether such patterns reflect a causal effect of case volume on patient outcomes. To this end, we exploit closures and openings of entire cancer clinics in Swedish hospitals which provides sharp and arguably exogenous variation in case volumes. Using detailed register data on more than 100,000 treatment episodes of advanced cancer surgery, our results suggest substantial positive effects of operation volume on survival. Complementary analyses point to learning-by-doing as an important explanation.

Suggested Citation

  • Avdic, Daniel & Lundborg, Petter & Vikström, Johan, 2019. "Estimating returns to hospital volume: Evidence from advanced cancer surgery," Journal of Health Economics, Elsevier, vol. 63(C), pages 81-99.
    • Handle: RePEc:eee:jhecon:v:63:y:2019:i:c:p:81-99
    DOI: 10.1016/j.jhealeco.2018.10.005
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    References listed on IDEAS

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    Citations

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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. Anders Van Sandt & Craig Wesley Carpenter & Rebekka Dudensing & Scott Loveridge, 2021. "Estimating determinants of healthcare establishment locations with restricted federal administrative data," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1328-1346, June.
    3. Felix Rösel, 2019. "Krankenhäuser auf dem Land: Bürger sind gegen längere Wege," ifo Dresden berichtet, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 26(05), pages 16-19, October.
    4. Sá, Luís & Straume, Odd Rune, 2021. "Quality provision in hospital markets with demand inertia: The role of patient expectations," Journal of Health Economics, Elsevier, vol. 80(C).
    5. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    6. Laurie Rachet-Jacquet & Nils Gutacker & Luigi Siciliani, 2019. "The causal effect of hospital volume on health gains from hip replacement surgery," Working Papers 168cherp, Centre for Health Economics, University of York.
    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. Kollerup, Anna, 2022. "Worth the trip? The effect of hospital clinic closures for patients undergoing scheduled surgery," Social Science & Medicine, Elsevier, vol. 314(C).
    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. Hanbit Lee & Eun Kyoung Choi & Kyung A. Min & Eunjeong Bae & Hooyun Lee & Jongsoo Lee, 2022. "Physician-Customized Strategies for Reducing Outpatient Waiting Time in South Korea Using Queueing Theory and Probabilistic Metamodels," IJERPH, MDPI, vol. 19(4), pages 1-15, February.
    11. Jakub Červený, 2023. "Selective referral or learning by doing? An analysis of hospital volume‐outcome relationship of vascular procedures," Health Economics, John Wiley & Sons, Ltd., vol. 32(6), pages 1344-1361, June.
    12. Balia, Silvia & Brau, Rinaldo & Moro, Daniela, 2020. "Choice of hospital and long-distances: Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 81(C).

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    More about this item

    Keywords

    Hospital case volume; Learning-by-doing; Cancer surgery; Survival; Causal effect;
    All these keywords.

    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
    • L11 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Production, Pricing, and Market Structure; Size Distribution of Firms

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