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Supply-Side Variation in the Use of Emergency Departments

Author

Listed:
  • Dan Zeltzer
  • Liran Einav
  • Avichai Chasid
  • Ran D. Balicer

Abstract

We study the role of person-specific and place-specific factors in explaining geographic variation in emergency department (ED) utilization using detailed data on 150,000 patients who moved regions within Israel. We document that about half of the destination-origin differences in the average ED utilization rate across districts translates to the change (up or down) in movers’ propensity to visit the ED. In contrast, we find no change in the probability of having an unplanned hospital admission (that is, via the ED), implying that the entire change in ED use by movers is driven by ED visits that do not lead to hospital admission. Similar results are obtained in a complementary event study, which uses hospital entry as a source of variation. The results from both approaches suggest that supply-side variation in ED access affects only the less severe cases—for which close substitutes likely exist—and that variation across ED physicians in their propensity to admit patients is not explained by place-specific factors, such as differences in incentives, capacity, or diagnostic quality.

Suggested Citation

  • Dan Zeltzer & Liran Einav & Avichai Chasid & Ran D. Balicer, 2020. "Supply-Side Variation in the Use of Emergency Departments," NBER Working Papers 28266, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:28266
    Note: AG EH IO PE
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    2. Johansson, Naimi & Jakobsson, Niklas & Svensson, Mikael, 2024. "Place or patient as the driver of regional variation in healthcare spending – Discrepancies by category of care," Social Science & Medicine, Elsevier, vol. 342(C).
    3. Hoagland, Alex & Wang, Guan, 2025. "Prescribing power and equitable access to care: Evidence from pharmacists in Ontario, Canada," Journal of Health Economics, Elsevier, vol. 103(C).
    4. Naimi Johansson & Mikael Svensson, 2022. "Regional variation in prescription drug spending: Evidence from regional migrants in Sweden," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1862-1877, September.
    5. Jacob, Nikita & Chalkley, Martin & Santos, Rita & Siciliani, Luigi, 2024. "Variation in attendance at emergency departments in England across local areas: A system under unequal pressure," Health Policy, Elsevier, vol. 150(C).

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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