The Role of Hospital Heterogeneity in Measuring Marginal Returns to Medical Care: A Reply to Barreca, Guldi, Lindo, and Waddell

In Almond et al. (2010), we describe how marginal returns to medical care can be estimated by comparing patients on either side of diagnostic thresholds. Our application examines at-risk newborns near the very low birth weight threshold at 1500 g. We estimate large discontinuities in medical care an...

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Bibliographic Details
Main Authors: Almond, Douglas (Author), Doyle, Joseph J. (Contributor), Kowalski, Amanda E. (Author), Williams, Heidi L. (Contributor)
Other Authors: Massachusetts Institute of Technology. Department of Economics (Contributor), Sloan School of Management (Contributor)
Format: Article
Language:English
Published: Oxford University Press, 2012-11-16T20:16:38Z.
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Summary:In Almond et al. (2010), we describe how marginal returns to medical care can be estimated by comparing patients on either side of diagnostic thresholds. Our application examines at-risk newborns near the very low birth weight threshold at 1500 g. We estimate large discontinuities in medical care and mortality at this threshold, with effects concentrated at "low-quality" hospitals. Although our preferred estimates retain newborns near the threshold, when they are excluded the estimated marginal returns decline, although they remain large. In low-quality hospitals, our estimates are similar in magnitude regardless of whether these newborns are included or excluded.