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Learning-by-Doing in a Highly Skilled Profession when Stakes are High: Evidence from Advanced Cancer Surgery

Author

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  • Avdic, Daniel

    (Uppsala Center for Labor Studies)

  • Lundborg, Petter

    (Lund University and IZA)

  • Vikström, Johan

    (Uppsala Center for Labor Studies)

Abstract

Although learning-by-doing is believed to be an important source of productivity growth, there is limited evidence that production volume affects productivity in a causal sense. We document evidence of learning-by-doing in a highly skilled profession where stakes are high; advanced cancer surgery. For this purpose, we introduce a novel instru- ment that exploits the closure and opening of entire cancer clinics which have given rise to sharp and exogenous changes in the cancer surgical volumes at Swedish public sec- tor hospitals. Using detailed register data on more than 100,000 episodes of advanced cancer surgery, our results suggest positive eects of surgery volumes on survival. In addition, we provide evidence on the mechanisms through which these improvements occur. We also show that the results are not driven by changes in patient composition or by other changes at the hospital level.

Suggested Citation

  • Avdic, Daniel & Lundborg, Petter & Vikström, Johan, 2014. "Learning-by-Doing in a Highly Skilled Profession when Stakes are High: Evidence from Advanced Cancer Surgery," Working Paper Series, Center for Labor Studies 2014:9, Uppsala University, Department of Economics.
  • Handle: RePEc:hhs:uulswp:2014_009
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    2. De Grip, Andries & Sauermann, Jan & Sieben, Inge, 2016. "The role of peers in estimating tenure-performance profiles: Evidence from personnel data," Journal of Economic Behavior & Organization, Elsevier, vol. 126(PA), pages 39-54.
    3. repec:zbw:rwirep:0527 is not listed on IDEAS
    4. 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.

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    More about this item

    Keywords

    hospital volume; learning-by-doing; cancer surgery; survival; causal effect;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L11 - Industrial Organization - - Market Structure, Firm Strategy, and Market Performance - - - Production, Pricing, and Market Structure; Size Distribution of Firms

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