Saving Lives by Tying Hands: The Unexpected Effects of Constraining Health Care Providers

• 成果类型: Article
• 署名作者: Gruber, Jonathan; Hoe, Thomas P.; Stoye, George
• 署名单位: Massachusetts Institute of Technology (MIT); National Bureau of Economic Research; Cornell University; University of London; London School Economics & Political Science
• 刊物名称: REVIEW OF ECONOMICS AND STATISTICS
• ISSN/ISSBN: 0034-6535
• DOI: 10.1162/rest_a_01044
• 发表日期: 2023-01
• 页码: 1-19
• 关键词: emergency-department; elasticities; responses; time

摘要

We study how emergency department (ED) doctors respond to incentives to reduce wait times. We use bunching techniques to study an English policy that imposed strong incentives to treat patients within four hours. The policy reduced time spent in the ED by 21 minutes for affected patients yet caused doctors to increase treatment intensity and admit more patients. We find a striking 14% reduction in mortality. Analysis of patient severity and hospital crowding strongly suggests it is the wait time reduction that saves lives. We conclude that, despite distorting medical decisions, constraining ED doctors can induce cost-effective reductions in mortality.