Innovation Diffusion under Budget Constraints: Microeconometric Evidence on Heart Attack in France
In: Contributions in Memory of Zvi Griliches
This paper studies the relationship between the diffusion of innovative procedures for the treatment of heart attack and the distributions of the cost and length of hospital stays. Using a sample of 5,681 stays observed in French publics hospitals, we use micro-simulation techniques in order to highlight various effects on the shifts in the overall distributions of the costs and length of stays: (i) the effect of the adoption of new techniques by hospitals (between hospital diffusion); (ii) the effect of the diffusion of technological progress within hospitals; (iii) the effect of the evolutions of patients characteristics (age x gender, co-morbidities). This decomposition approach is used in the literature relative to the relationship between education and income distribution where observed distributions are compared to counterfactual distributions built by replacing some estimated parameters with their counterparts estimated from another country or period. Our results show that between 1994 and 1997 hospitals faced two main causes of rises in costs: on the one hand, diffusion of technological progress, with increasing use of costly innovative procedures such as angioplasty; on the other hand, patients' epidemiological state worsened, since they became older and had more secondary diagnoses. These two factors induced sizeable shocks in cost distributions. During the same period, French public hospitals were financed by a global budget, and their budgets increased very slowly. International comparisons show that diffusion of technological progress for AMI treatment is similar in France and in comparable countries. How did French hospitals deal with their financial constraints? Our results show that they sharply reduced the length of stays for patients at the bottom of the distribution. This reduction in the length of stays appears to have been a condition for the diffusion of angioplasty. Obviously, such a condition cannot be sustained in the long run without jeopar
(This abstract was borrowed from another version of this item.)
To our knowledge, this item is not available for
download. To find whether it is available, there are three
1. Check below under "Related research" whether another version of this item is available online.
2. Check on the provider's web page whether it is in fact available.
3. Perform a search for a similarly titled item that would be available.
|This chapter was published in: ||This item is provided by National Bureau of Economic Research, Inc in its series NBER Chapters with number
12251.||Handle:|| RePEc:nbr:nberch:12251||Contact details of provider:|| Postal: |
Web page: http://www.nber.org
More information through EDIRC
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Juhn, Chinhui & Murphy, Kevin M & Pierce, Brooks, 1993. "Wage Inequality and the Rise in Returns to Skill," Journal of Political Economy, University of Chicago Press, vol. 101(3), pages 410-42, June.
- Dinardo, J. & Fortin, N.M. & Lemieux, T., 1994.
"Labor Market Institutions and the Distribution of Wages, 1973-1992: A Semiparametric Approach,"
Cahiers de recherche
9406, Centre interuniversitaire de recherche en économie quantitative, CIREQ.
- DiNardo, John & Fortin, Nicole M & Lemieux, Thomas, 1996. "Labor Market Institutions and the Distribution of Wages, 1973-1992: A Semiparametric Approach," Econometrica, Econometric Society, vol. 64(5), pages 1001-44, September.
- Nidardo, J. & Fortin, N. & Lemieux, T., 1994. "Labor Market Institutions and the Distribution of Wages, 1973-1992: A Semiparametric Approach," Papers 93-94-15, California Irvine - School of Social Sciences.
- John DiNardo & Nicole M. Fortin & Thomas Lemieux, 1995. "Labor Market Institutions and the Distribution of Wages, 1973-1992: A Semiparametric Approach," NBER Working Papers 5093, National Bureau of Economic Research, Inc.
- Dinardo, J. & Fortin, N.M. & Lemieux, T., 1994. "Labor Market Institutions and the Distribution of Wages, 1973-1992: a Semiparametric Approach," Cahiers de recherche 9406, Universite de Montreal, Departement de sciences economiques.
- Dormont, Brigitte & Milcent, Carine, 2005.
"How to regulate heterogeneous hospitals ?,"
Economics Papers from University Paris Dauphine
123456789/5425, Paris Dauphine University.
- Brigitte Dormont, 2003. "How to Regulate Heterogeneous Hospistals," THEMA Working Papers 2003-11, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
- Brigitte Dormont & Carine Milcent, 2003. "How to regulate heterogenous hospitals?," DELTA Working Papers 2003-19, DELTA (Ecole normale supérieure).
When requesting a correction, please mention this item's handle: RePEc:nbr:nberch:12251. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ()
If references are entirely missing, you can add them using this form.