Selective-referral and Unobserved Patient Heterogeneity – Bias in the Volume-outcome Relationship

Arbeitspapier

This paper examines the causal effect of the experience of a hospital with treating hip fractures (volume) on treatment outcome for patients. A full sample of administrative data from Germany for the year 2007 is used. We apply an instrumental variable approach to eliminate endogeneity concerns due to reverse causality and unobserved patient heterogeneity. As instruments for case volume we use the number of potential patients and the number of further hospitals in the region around every hospital. Our results indicate that after application of an IV regression of volume on outcome, volume significantly increases quality.

Object Details

• ISBN: 978-3-86788-602-4
• Language: Englisch

References and Relationships

• Bibliographic citation: Series: Ruhr Economic Papers ; No. 527

Classification and Topics

• Classification: Wirtschaft ; Analysis of Health Care Markets ; Health Behavior ; Health: Government Policy; Regulation; Public Health
• Subject: volume ; hospital quality ; mortality ; instrumental variables

Contributors, Places and Time

• Event: Geistige Schöpfung
• (who): Hentschker, Corinna ; Mennicken, Roman
• Event: Veröffentlichung
• (who): Rheinisch-Westfälisches Institut für Wirtschaftsforschung (RWI)
• (where): Essen
• (when): 2014

Further information

• DOI: doi:10.4419/86788602
• Handle: http://hdl.handle.net/10419/104736
• Last update: 10.03.2025, 11:41 AM CET