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Selective-referral and unobserved patient heterogeneity - Bias in the volume-outcome relationship

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  • Hentschker, Corinna
  • Mennicken, Roman

Abstract

This paper examines the causal effect of volume on outcome on the example of patients with a hip fracture. We use an instrumental variable approach and consider both the practice-makes-perfect and selective-referral hypothesis as well as unobserved patient heterogeneity. Our results indicate that unobserved severity drives the results in the volume-outcome relationship for hip fracture patients and with this the practice-makes-perfect hypothesis has an even stronger effect on hospital quality than expected so far.

Suggested Citation

  • Hentschker, Corinna & Mennicken, Roman, 2014. "Selective-referral and unobserved patient heterogeneity - Bias in the volume-outcome relationship," Annual Conference 2014 (Hamburg): Evidence-based Economic Policy 100299, Verein für Socialpolitik / German Economic Association.
  • Handle: RePEc:zbw:vfsc14:100299
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    References listed on IDEAS

    as
    1. Gaynor, Martin & Town, Robert J., 2011. "Competition in Health Care Markets," Handbook of Health Economics, Elsevier.
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    5. 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.
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    14. repec:zbw:rwirep:0469 is not listed on IDEAS
    15. Mennicken, Roman & Kolodziej, Ingo W.K. & Augurzky, Boris & Kreienberg, Rolf, 2014. "Concentration of gynaecology and obstetrics in Germany: Is comprehensive access at stake?," Health Policy, Elsevier, vol. 118(3), pages 396-406.
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    More about this item

    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

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