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Forgetting the learning curve for a moment: how much performance is un related to own experience?

  • Marco D. Huesch

    (Policy Academic Area, The Anderson Graduate School of Management, Los Angeles, CA, USA)

  • Mariko Sakakibara

    (Policy Academic Area, The Anderson Graduate School of Management, Los Angeles, CA, USA)

Registered author(s):

    Volume-outcome relationships are of clear importance for most participants in the health-care industry; research and appropriate policy implications are of critical importance. In this letter we critique the prevailing 'learning-by-doing' view in cardiac surgery. We illustrate the very wide disparity in empirical findings on volume-outcome relationships there, in the context of broader open issues in 'learning curves' in general. Potential complementary mechanisms, e.g. 'social learning by knowledge spillovers' are introduced; these cast into doubt the prevailing policy recommendations of simple regionalization and volume smoothing. Copyright © 2008 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.1412
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    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 18 (2009)
    Issue (Month): 7 ()
    Pages: 855-862

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    Handle: RePEc:wly:hlthec:v:18:y:2009:i:7:p:855-862
    Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. Amitabh Chandra & Douglas O. Staiger, 2007. "Productivity Spillovers in Health Care: Evidence from the Treatment of Heart Attacks," Journal of Political Economy, University of Chicago Press, vol. 115, pages 103-140.
    2. Linda Argote & Sara L. Beckman & Dennis Epple, 1990. "The Persistence and Transfer of Learning in Industrial Settings," Management Science, INFORMS, vol. 36(2), pages 140-154, February.
    3. Irwin, Douglas A & Klenow, Peter J, 1994. "Learning-by-Doing Spillovers in the Semiconductor Industry," Journal of Political Economy, University of Chicago Press, vol. 102(6), pages 1200-1227, December.
    4. Martin Gaynor & Harald Seider & William B. Vogt, 2005. "The Volume–Outcome Effect, Scale Economies, and Learning-by-Doing," American Economic Review, American Economic Association, vol. 95(2), pages 243-247, May.
    5. Mary A. Burke & Gary M. Fournier & Kislaya Prasad, 2007. "The Diffusion of a Medical Innovation: Is Success in the Stars?," Southern Economic Journal, Southern Economic Association, vol. 73(3), pages 588–603, January.
    6. Robert S. Huckman & Gary P. Pisano, 2006. "The Firm Specificity of Individual Performance: Evidence from Cardiac Surgery," Management Science, INFORMS, vol. 52(4), pages 473-488, April.
    7. Ray Reagans & Linda Argote & Daria Brooks, 2005. "Individual Experience and Experience Working Together: Predicting Learning Rates from Knowing Who Knows What and Knowing How to Work Together," Management Science, INFORMS, vol. 51(6), pages 869-881, June.
    8. Ron Jarmin, 1993. "Learning By Doing And Competition In The Early Rayon Industry," Working Papers 93-4, Center for Economic Studies, U.S. Census Bureau.
    9. Gary P. Pisano & Richard M.J. Bohmer & Amy C. Edmondson, 2001. "Organizational Differences in Rates of Learning: Evidence from the Adoption of Minimally Invasive Cardiac Surgery," Management Science, INFORMS, vol. 47(6), pages 752-768, June.
    10. Samuel Hollander, 1965. "The Sources of Increased Efficiency: A Study of DuPont Rayon Plants," MIT Press Books, The MIT Press, edition 1, volume 1, number 026258235x, June.
    11. Nile W. Hatch & David C. Mowery, 1998. "Process Innovation and Learning by Doing in Semiconductor Manufacturing," Management Science, INFORMS, vol. 44(11-Part-1), pages 1461-1477, November.
    12. Ho, Vivian, 2002. "Learning and the evolution of medical technologies: the diffusion of coronary angioplasty," Journal of Health Economics, Elsevier, vol. 21(5), pages 873-885, September.
    13. C. Lanier Benkard, 2000. "Learning and Forgetting: The Dynamics of Aircraft Production," American Economic Review, American Economic Association, vol. 90(4), pages 1034-1054, September.
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