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The Role of Hospital Heterogeneity in Measuring Marginal Returns to Medical Care: A Reply to Barreca, Guldi, Lindo, and Waddell

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  • Douglas Almond
  • Joseph J. Doyle
  • Amanda E. Kowalski
  • Heidi Williams

Abstract

In , we describe how marginal returns to medical care can be estimated by comparing patients on either side of diagnostic thresholds. Our application examines at-risk newborns near the very low birth weight threshold at 1500 g. We estimate large discontinuities in medical care and mortality at this threshold, with effects concentrated at "low-quality" hospitals. Although our preferred estimates retain newborns near the threshold, when they are excluded the estimated marginal returns decline, although they remain large. In low-quality hospitals, our estimates are similar in magnitude regardless of whether these newborns are included or excluded. Copyright 2011, Oxford University Press.

Suggested Citation

  • Douglas Almond & Joseph J. Doyle & Amanda E. Kowalski & Heidi Williams, 2011. "The Role of Hospital Heterogeneity in Measuring Marginal Returns to Medical Care: A Reply to Barreca, Guldi, Lindo, and Waddell," The Quarterly Journal of Economics, Oxford University Press, vol. 126(4), pages 2125-2131.
  • Handle: RePEc:oup:qjecon:v:126:y:2011:i:4:p:2125-2131
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    File URL: http://hdl.handle.net/10.1093/qje/qjr037
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    Cited by:

    1. repec:spr:stpapr:v:58:y:2017:i:4:d:10.1007_s00362-016-0745-z is not listed on IDEAS
    2. Zhuan Pei & Yi Shen, 2017. "The Devil is in the Tails: Regression Discontinuity Design with Measurement Error in the Assignment Variable," Advances in Econometrics,in: Regression Discontinuity Designs, volume 38, pages 455-502 Emerald Publishing Ltd.
    3. Reif, S.; Wichert, S.; Wuppermann, A.;, 2017. "Is it good to be too light? Birth weight thresholds in hospital reimbursement systems," Health, Econometrics and Data Group (HEDG) Working Papers 17/15, HEDG, c/o Department of Economics, University of York.

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