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Quarterly Journal of Economics Vol. 126 No. 4 2011

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

Douglas Almond1; Joseph Doyle; Amanda Kowalski; Heidi Williams

1 National Bureau of Economic Research

open access

Abstract

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.

DOI
10.1093/qje/qjr037
Volume
126
Issue
4
Pages
2125-2131
Language
en
Sources
bibtex:phds-export.bib openalex crossref

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