IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v6y1997i4p383-395.html

Estimating surgical volume—outcome relationships applying survival models: accounting for frailty and hospital fixed effects

Author

Listed:
  • Barton H. Hamilton
  • Vivian H. Hamilton

Abstract

This paper investigates the surgical volume–outcome relationship for patients undergoing hip fracture surgery in Quebec between 1991 and 1993. Using a duration model with multiple destinations which accounts for observed and unobserved (by the researcher) patient characteristics, our initial estimates show that higher surgical volume is associated with a higher conditional probability of live discharge from the hospital. However, these results reflect differences between hospitals rather than differences within hospitals over time: when we also control for differences between hospitals that are fixed over time, hospitals performing more surgeries in period t + 1 than in period t experience no significant change in outcomes, as would be predicted by the ‘practice makes perfect’ hypothesis. The volume–outcome relationship for hip fracture patients thus appears to reflect quality differences between high and low volume hospitals. © 1997 John Wiley & Sons, Ltd.

Suggested Citation

  • Barton H. Hamilton & Vivian H. Hamilton, 1997. "Estimating surgical volume—outcome relationships applying survival models: accounting for frailty and hospital fixed effects," Health Economics, John Wiley & Sons, Ltd., vol. 6(4), pages 383-395, July.
    • Handle: RePEc:wly:hlthec:v:6:y:1997:i:4:p:383-395
    DOI: 10.1002/(SICI)1099-1050(199707)6:4<383::AID-HEC278>3.0.CO;2-L
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/(SICI)1099-1050(199707)6:43.0.CO;2-L
    Download Restriction: no
    File URL: https://libkey.io/10.1002/(SICI)1099-1050(199707)6:4<383::AID-HEC278>3.0.CO;2-L?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Heckman, James & Singer, Burton, 1984. "A Method for Minimizing the Impact of Distributional Assumptions in Econometric Models for Duration Data," Econometrica, Econometric Society, vol. 52(2), pages 271-320, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Laurent Gobillon & Carine Milcent, 2013. "Spatial disparities in hospital performance," Journal of Economic Geography, Oxford University Press, vol. 13(6), pages 1013-1040, November.
    2. Andrew E. Clark & Carine Milcent, 2008. "Keynesian hospitals? Public employment and political pressure," PSE Working Papers halshs-00586792, HAL.
    3. Hentschker, Corinna & Mennicken, Roman, 2012. "The Relationship between Quality and Hospital Case Volume – An Empirical Examination with German Data," Ruhr Economic Papers 341, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    4. Pauly, Mark V. & Burns, Lawton Robert & Benitez, Alejandra & Sielski, Michael, 2025. "Hospital consolidation and quality: Opening the behavioral black box," Social Science & Medicine, Elsevier, vol. 386(C).
    5. Clark, Andrew E. & Milcent, Carine, 2011. "Public employment and political pressure: The case of French hospitals," Journal of Health Economics, Elsevier, vol. 30(5), pages 1103-1112.
    6. Hentschker, Corinna & Mennicken, Roman, 2014. "Selective-referral and unobserved patient heterogeneity - Bias in the volume-outcome relationship," VfS Annual Conference 2014 (Hamburg): Evidence-based Economic Policy 100299, Verein für Socialpolitik / German Economic Association.
    7. W. David Bradford & Andrew N. Kleit & Paul J. Nietert & Steven Ornstein, 2010. "The Effect Of Direct To Consumer Television Advertising On The Timing Of Treatment," Economic Inquiry, Western Economic Association International, vol. 48(2), pages 306-322, April.
    8. Andrew Sfekas, 2009. "Learning, forgetting, and hospital quality: an empirical analysis of cardiac procedures in Maryland and Arizona," Health Economics, John Wiley & Sons, Ltd., vol. 18(6), pages 697-711, June.
    9. Woohyeon Kim & Stephen Wolff & Vivian Ho, 2016. "Measuring the Volume-Outcome Relation for Complex Hospital Surgery," Applied Health Economics and Health Policy, Springer, vol. 14(4), pages 453-464, August.
    10. Robin Thompson & Ana Xavier, 2004. "Are Patients in the Transition World Paying Unofficially to Stay Longer in Hospital? Some Evidence from Kazakhstan," LICOS Discussion Papers 14004, LICOS - Centre for Institutions and Economic Performance, KU Leuven.
    11. M. Lippi Bruni & C. Ugolini & R. Verzulli, 2018. "Disentangling the effect of waiting times on hospital choice: Evidence from a panel data analysis," Working Papers wp1118, Dipartimento Scienze Economiche, Universita' di Bologna.
    12. Justin G. Trogdon, 2009. "Demand For And Regulation Of Cardiac Services," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 50(4), pages 1183-1204, November.
    13. 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.
    14. Corinna Hentschker & Roman Mennicken, 2014. "Selective-referral and Unobserved Patient Heterogeneity – Bias in the Volume-outcome Relationship," Ruhr Economic Papers 0527, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    15. 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.
    16. Carine Milcent, 2005. "Hospital ownership, reimbursement systems and mortality rates," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1151-1168, November.
    17. Avdic, Daniel & Lundborg, Petter & Vikström, Johan, 2014. "Learning-by-Doing in a High-Skill Profession when Stakes are High: Evidence from Advanced Cancer Surgery," VfS Annual Conference 2014 (Hamburg): Evidence-based Economic Policy 100278, Verein für Socialpolitik / German Economic Association.
    18. Corinna Hentschker & Roman Mennicken, 2015. "The Volume‐Outcome Relationship and Minimum Volume Standards – Empirical Evidence for Germany," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 644-658, June.
    19. Corinna Hentschker & Roman Mennicken, 2012. "The Relationship between Quality and Hospital Case Volume – An Empirical Examination with German Data," Ruhr Economic Papers 0341, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    20. repec:hal:pseose:halshs-00879787 is not listed on IDEAS
    21. Justin G. Trogdon, 2004. "Regionalization of Cardiac Services and the Responsiveness of Treatment Choices," Adelaide Economics Working Papers 2004-03, Adelaide University, School of Economics.
    22. 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.
    23. David Barker & Gary Rosenthal & Peter Cram, 2011. "Simultaneous relationships between procedure volume and mortality: do they bias studies of mortality at specialty hospitals?," Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 505-518, May.
    24. Avdic, Daniel & Lundborg, Petter & Vikström, Johan, 2014. "Learning-by-Doing in a Highly Skilled Profession When Stakes Are High: Evidence from Advanced Cancer Surgery," IZA Discussion Papers 8099, IZA Network @ LISER.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Patrick Arni & Rafael Lalive & Jan C. Van Ours, 2013. "How Effective Are Unemployment Benefit Sanctions? Looking Beyond Unemployment Exit," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 28(7), pages 1153-1178, November.
    2. Kemptner, Daniel & Tolan, Songül, 2018. "The role of time preferences in educational decision making," Economics of Education Review, Elsevier, vol. 67(C), pages 25-39.
    3. Christelis, Dimitris & Dobrescu, Loretti I. & Motta, Alberto, 2020. "Early life conditions and financial risk-taking in older age," The Journal of the Economics of Ageing, Elsevier, vol. 17(C).
    4. Michelle Sheran Sylvester, 2007. "The Career and Family Choices of Women: A Dynamic Analysis of Labor Force Participation, Schooling, Marriage and Fertility Decisions," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics, vol. 10(3), pages 367-399, July.
    5. Insoo Cho & Peter F. Orazem, 2021. "How endogenous risk preferences and sample selection affect analysis of firm survival," Small Business Economics, Springer, vol. 56(4), pages 1309-1332, April.
    6. Ali Palali & Jan C. Van ours, 2017. "Love Conquers all but Nicotine: Spousal Peer Effects on the Decision to Quit Smoking," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1710-1727, December.
    7. Steven M. Lewis & Adrian E. Raftery, 1999. "Bayesian Analysis of Event History Models with Unobserved Heterogeneity via Markov Chain Monte Carlo," Sociological Methods & Research, , vol. 28(1), pages 35-60, August.
    8. Francesco Devicienti & Valentina Gualtieri & Mariacristina Rossi, 2014. "The Persistence Of Income Poverty And Lifestyle Deprivation: Evidence From Italy," Bulletin of Economic Research, Wiley Blackwell, vol. 66(3), pages 246-278, July.
    9. Elena Casquel & Antoni Cunyat, "undated". "The Welfare Cost of Business Cycles in an Economy with Nonclearing Markets," Working Papers 2005-19, FEDEA.
    10. Cockx, Bart & Robin, Stéphane R. & Goebel, Christian, 2006. "Income Support Policies for Part-Time Workers: A Stepping-Stone to Regular Jobs? An Application to Young Long-Term Unemployed Women in Belgium," IZA Discussion Papers 2432, IZA Network @ LISER.
    11. Hoffman, Mitchell & Burks, Stephen V., 2017. "Worker Overconfidence: Field Evidence and Implications for Employee Turnover and Returns from Training," IZA Discussion Papers 10794, IZA Network @ LISER.
    12. Pan, Wei & Louis, Thomas A., 1999. "Two semi-parametric empirical Bayes estimators," Computational Statistics & Data Analysis, Elsevier, vol. 30(2), pages 185-196, April.
    13. John Cawley & James Heckman & Edward Vytlacil, 1998. "Meritocracy in America: An Examination of Wages Within and Across Occupations," NBER Working Papers 6446, National Bureau of Economic Research, Inc.
    14. Hernaes, Erik & Markussen, Simen & Piggott, John & Vestad, Ola L., 2013. "Does retirement age impact mortality?," Journal of Health Economics, Elsevier, vol. 32(3), pages 586-598.
    15. Fevang, Elisabeth & Hardoy, Inés & Røed, Knut, 2013. "Getting Disabled Workers Back to Work: How Important Are Economic Incentives?," IZA Discussion Papers 7137, IZA Network @ LISER.
    16. Moreno Gigi & van Eijndhoven Emma & Benner Jennifer & Sullivan Jeffrey, 2017. "The Long-Term Impact of Price Controls in Medicare Part D," Forum for Health Economics & Policy, De Gruyter, vol. 20(2), pages 1-56, December.
    17. Dorsett, Richard, 2014. "The effect of temporary in-work support on employment retention: Evidence from a field experiment," Labour Economics, Elsevier, vol. 31(C), pages 61-71.
    18. Hanel, Barbara & Riphahn, Regina T., 2012. "The timing of retirement — New evidence from Swiss female workers," Labour Economics, Elsevier, vol. 19(5), pages 718-728.
    19. Jackson Bunting, 2022. "Continuous permanent unobserved heterogeneity in dynamic discrete choice models," Papers 2202.03960, arXiv.org, revised Sep 2025.
    20. Kai Hong & Peter A. Savelyev & Kegon T. K. Tan, 2020. "Understanding the Mechanisms Linking College Education with Longevity," Journal of Human Capital, University of Chicago Press, vol. 14(3), pages 371-400.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:6:y:1997:i:4:p:383-395. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.