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

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  • Marco D. Huesch
  • Mariko Sakakibara

Abstract

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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  • Marco D. Huesch & Mariko Sakakibara, 2009. "Forgetting the learning curve for a moment: how much performance is unrelated to own experience?," Health Economics, John Wiley & Sons, Ltd., vol. 18(7), pages 855-862, July.
    • Handle: RePEc:wly:hlthec:v:18:y:2009:i:7:p:855-862
    DOI: 10.1002/hec.1412
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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. Mario Benassi & Elena Grinza & Francesco Rentocchini & Laura Rondi, 2020. "Going Revolutionary: The Impact of 4IR Technology Development on Firm Performance," SPRU Working Paper Series 2020-08, SPRU - Science Policy Research Unit, University of Sussex Business School.
    3. Vivian Ho & Woohyeon Kim & Stephen Wolff, 2017. "Authors’ Reply to Luft: “Measuring the Volume-Outcome Relation for Complex Hospital Surgery”," Applied Health Economics and Health Policy, Springer, vol. 15(4), pages 537-538, August.
    4. Kollerup, Anna & Wadmann, Sarah & Bek, Toke & Kjellberg, Jakob, 2022. "National clinical guidelines and treatment centralization do not guarantee consistency in healthcare delivery. A mixed-methods study of wet age-related macular degeneration treatment in Denmark," Health Policy, Elsevier, vol. 126(12), pages 1291-1302.
    5. Gaynor, Martin & Town, Robert J., 2011. "Competition in Health Care Markets," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 499-637, Elsevier.
    6. Bauer, Carsten & Möbs, Nele & Unger, Oliver & Szczesny, Andrea & Ernst, Christian, 2020. "Spillover Effects of Specialization Strategies in Hospitals: An Analysis of the Effects in the Short, Medium, and Long Term," EconStor Preprints 215783, ZBW - Leibniz Information Centre for Economics.
    7. Frank R. Lichtenberg & Johannes Schoder, 2010. "Impact of Specialization on Health Outcomes – Evidence from U.S. Cancer Data," SOI - Working Papers 1011, Socioeconomic Institute - University of Zurich.
    8. Gestel, R.V. & Müller, T. & Bosmans, J., 2016. "Does My High Blood Pressure Improve Your Survival? Overall and Subgroup Learning Curves in Health," Health, Econometrics and Data Group (HEDG) Working Papers 16/27, HEDG, c/o Department of Economics, University of York.
    9. Kollerup, Anna, 2022. "Worth the trip? The effect of hospital clinic closures for patients undergoing scheduled surgery," Social Science & Medicine, Elsevier, vol. 314(C).
    10. 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.
    11. Stock, Gregory N. & McDermott, Christopher & Anand, Gopesh, 2016. "Average surgeon-level volume and hospital performance," International Journal of Production Economics, Elsevier, vol. 182(C), pages 253-262.

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