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Quasi-experimental evidence on the effectiveness of heart attack treatment in Germany


  • Corinna Hentschker

    () (RWI -- Leibniz Institute for Economic Research and Leibniz Science Campus Ruhr)

  • Ansgar Wuebker

    (RWI -- Leibniz Institute for Economic Research, Ruhr-University Bochum and Leibniz Science Campus Ruhr)


Objective. To examine the causal effect of percutaneous transluminal coronary angioplasty (PTCA) in comparison to conservative treatment methods on mortality. Data Sources. We use a full sample of administrative hospital data from Germany for the years 2005 to 2007. Study Design. To account for non-random treatment assignment of PTCA, instrumental variable approaches are implemented that aim to randomize patients into getting PTCA independent of heart attack severity. Instruments include differential distances to PTCA hospitals and regional PTCA rates. Principal Findings. Our results suggest a 4.5 percentage point mortality reduction for patients who have access to PTCA compared to patients receiving only conservative treatment. We relate mortality reduction to the additional costs for this treatment and conclude that PTCA treatment is cost-effective in lowering mortality for AMI patients at reasonable cost-effectiveness thresholds. Conclusions. Our local average treatment effect results suggest that PTCA treatment could be beneficial, at least for the group that did not receive PTCA because the nearest hospital did not provide PTCA.

Suggested Citation

  • Corinna Hentschker & Ansgar Wuebker, 2018. "Quasi-experimental evidence on the effectiveness of heart attack treatment in Germany," CINCH Working Paper Series 1804, Universitaet Duisburg-Essen, Competent in Competition and Health.
  • Handle: RePEc:duh:wpaper:1804

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    References listed on IDEAS

    1. Alice Sanwald & Thomas Schober, 2014. "Follow your Heart: Survival Chances and Costs after Heart Attacks - An Instrumental Variable Approach," Economics working papers 2014-12, Department of Economics, Johannes Kepler University Linz, Austria.
    2. Ankit Kumar & Michael Schoenstein, 2013. "Managing Hospital Volumes: Germany and Experiences from OECD Countries," OECD Health Working Papers 64, OECD Publishing.
    3. Schwierz, Christoph & Wübker, Ansgar, 2009. "Determinants of Avoidable Deaths from Ischaemic Heart Diseases in East and West Germany," Ruhr Economic Papers 119, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    4. Hentschker, Corinna, 2017. "From dusk till dawn - Are nights a dangerous time for hospital admissions?," Annual Conference 2017 (Vienna): Alternative Structures for Money and Banking 168056, Verein für Socialpolitik / German Economic Association.
    5. Budde, Rüdiger & Eilers, Lea, 2014. "Sozioökonomische Daten auf Rasterebene: Datenbeschreibung der microm-Rasterdaten," RWI Materialien 77, RWI - Leibniz-Institut für Wirtschaftsforschung.
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