IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v29y2010i4p603-615.html
   My bibliography  Save this article

Population density and racial differences in the performance of emergency medical services

Author

Listed:
  • David, Guy
  • Harrington, Scott E.

Abstract

This paper analyzes the existence and scope of possible racial differences/disparities in the provision of emergency medical services (EMS) response capability (time from dispatch to arrival at the scene and level of training of the responding team) using data on approximately 120,000 cardiac incidents in the state of Mississippi during 1995-2004. The conceptual framework and empirical analysis focus on the likely effects of population density on the efficient production of EMS as a local public good subject to congestion, and on the need to control adequately for population density to avoid bias in testing for racial differences. Models that control for aggregate population density at the county-level indicate "reverse" disparities: faster estimated response times for African-Americans than for whites. When a refined county-level measure of population density is used that incorporates differences in African-American and white population density by Census tract, the reverse disparity in response times disappears. There also is little or no evidence of race-related differences in the certification level of EMS responders. However, there is evidence that, controlling for response time, African-Americans on average were significantly more likely to be deceased than whites upon EMS arrival at the scene. The overall results are germane to the debate over the scope of conditioning variables that should be included when testing for racial disparities in health care.

Suggested Citation

  • David, Guy & Harrington, Scott E., 2010. "Population density and racial differences in the performance of emergency medical services," Journal of Health Economics, Elsevier, vol. 29(4), pages 603-615, July.
  • Handle: RePEc:eee:jhecon:v:29:y:2010:i:4:p:603-615
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167-6296(10)00045-7
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health Evidence from Medicare," Working Papers WR-197, RAND Corporation.
    2. Susan Athey & Scott Stern, 2002. "The Impact of Information Technology on Emergency Health Care Outcomes," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 399-432, Autumn.
    3. Balsa, Ana I. & McGuire, Thomas G., 2003. "Prejudice, clinical uncertainty and stereotyping as sources of health disparities," Journal of Health Economics, Elsevier, vol. 22(1), pages 89-116, January.
    4. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," NBER Working Papers 10365, National Bureau of Economic Research, Inc.
    5. Brueckner, Jan K., 1981. "Congested public goods: The case of fire protection," Journal of Public Economics, Elsevier, vol. 15(1), pages 45-58, February.
    6. Balsa, Ana I. & Cao, Zhun & McGuire, Thomas G., 2007. "Does managed health care reduce health care disparities between minorities and Whites?," Journal of Health Economics, Elsevier, vol. 26(1), pages 101-121, January.
    7. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Courtemanche, Charles & Friedson, Andrew & Koller, Andrew P. & Rees, Daniel I., 2019. "The affordable care act and ambulance response times," Journal of Health Economics, Elsevier, vol. 67(C).
    2. Tanguy Brachet & Guy David & Andrea M. Drechsler, 2012. "The Effect of Shift Structure on Performance," American Economic Journal: Applied Economics, American Economic Association, vol. 4(2), pages 219-246, April.
    3. Elena Lucchese, 2020. "Where are you? The problem of location during emergencies," Working Papers 439, University of Milano-Bicocca, Department of Economics, revised Apr 2020.
    4. Suriyaphong Nilsang & Chumpol Yuangyai & Chen-Yang Cheng & Udom Janjarassuk, 2019. "Locating an ambulance base by using social media: a case study in Bangkok," Annals of Operations Research, Springer, vol. 283(1), pages 497-516, December.
    5. Zhang, Cai Wen & Yang, Yuanhui, 2023. "Appraisal of regional hospital efficiency and healthcare quality in China: Impacts of subsidies and marketization," Socio-Economic Planning Sciences, Elsevier, vol. 89(C).
    6. Ranon Jientrakul & Chumpol Yuangyai & Klongkwan Boonkul & Pakinai Chaicharoenwut & Suriyaphong Nilsang & Sittiporn Pimsakul, 2022. "Integrating Spatial Risk Factors with Social Media Data Analysis for an Ambulance Allocation Strategy: A Case Study in Bangkok," Sustainability, MDPI, vol. 14(16), pages 1-15, August.
    7. Elizabeth Ty Wilde, 2013. "Do Emergency Medical System Response Times Matter For Health Outcomes?," Health Economics, John Wiley & Sons, Ltd., vol. 22(7), pages 790-806, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. David Frisvold & Ezra Golberstein, 2013. "The Effect of School Quality on Black-White Health Differences: Evidence From Segregated Southern Schools," Demography, Springer;Population Association of America (PAA), vol. 50(6), pages 1989-2012, December.
    2. Linda Dynan, 2009. "The Contribution of Economists to Understanding Racial Health Disparities in the US," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(3), pages 213-223, September.
    3. Nicolas Moreau & Elena Stancanelli, 2015. "Household Consumption at Retirement : A Regression Discontinuity Study on French Data," Annals of Economics and Statistics, GENES, issue 117-118, pages 253-276.
    4. Christelis, Dimitris & Georgarakos, Dimitris & Sanz-de-Galdeano, Anna, 2020. "The impact of health insurance on stockholding: A regression discontinuity approach," Journal of Health Economics, Elsevier, vol. 69(C).
    5. Greenstone, Michael & Gayer, Ted, 2009. "Quasi-experimental and experimental approaches to environmental economics," Journal of Environmental Economics and Management, Elsevier, vol. 57(1), pages 21-44, January.
    6. Elena Stancanelli & Arthur Van Soest, 2012. "Joint Leisure Before and After Retirement: a double Regression Discontinuity Approach," Documents de travail du Centre d'Economie de la Sorbonne 12085, Université Panthéon-Sorbonne (Paris 1), Centre d'Economie de la Sorbonne.
    7. Guido W. Imbens & Jeffrey M. Wooldridge, 2009. "Recent Developments in the Econometrics of Program Evaluation," Journal of Economic Literature, American Economic Association, vol. 47(1), pages 5-86, March.
    8. Norihiro Komura & Shun-ichiro Bessho, 2022. "The Longer-term Impact of Coinsurance for the Elderly - Evidence from High-access Case -," KIER Working Papers 1074, Kyoto University, Institute of Economic Research.
    9. Black, Bernard & Hollingsworth, Alex & Nunes, Letícia & Simon, Kosali, 2022. "Simulated power analyses for observational studies: An application to the Affordable Care Act Medicaid expansion," Journal of Public Economics, Elsevier, vol. 213(C).
    10. Bernard Black & José-Antonio Espín-Sánchez & Eric French & Kate Litvak, 2017. "The Long-Term Effect of Health Insurance on Near-Elderly Health and Mortality," American Journal of Health Economics, University of Chicago Press, vol. 3(3), pages 281-311, Summer.
    11. Hoke, Omer & Dunn, Richard, 2016. "The Effect of Early ACA Medicaid Expansion on Mental Health," Working Paper series 290123, University of Connecticut, Charles J. Zwick Center for Food and Resource Policy.
    12. Zhan Cao & Yizhou Tang, 2021. "The effect of increasing retirement age on consumption in China," Asian-Pacific Economic Literature, The Crawford School, The Australian National University, vol. 35(2), pages 136-150, November.
    13. Khwaja, Ahmed, 2010. "Estimating willingness to pay for medicare using a dynamic life-cycle model of demand for health insurance," Journal of Econometrics, Elsevier, vol. 156(1), pages 130-147, May.
    14. Imbens, Guido W. & Lemieux, Thomas, 2008. "Regression discontinuity designs: A guide to practice," Journal of Econometrics, Elsevier, vol. 142(2), pages 615-635, February.
    15. Guido Citoni, 2015. "On the inverse relationship between ex-ante and ex-post moral hazard: the case of smokers," Working Papers CEB 15-041, ULB -- Universite Libre de Bruxelles.
    16. Tomas J. Philipson & Gary Becker & Dana Goldman & Kevin M. Murphy, 2010. "Terminal Care and The Value of Life Near Its End," NBER Working Papers 15649, National Bureau of Economic Research, Inc.
    17. Genevieve E O'Connor, 2016. "Investigating the significance of insurance and income on health service utilization across generational cohorts," Journal of Financial Services Marketing, Palgrave Macmillan, vol. 21(1), pages 19-33, March.
    18. Sam Peltzman, 2014. "Socialized medicine and mortality," International Journal of Health Economics and Management, Springer, vol. 14(3), pages 179-205, September.
    19. Ofer Malamud & Cristian Pop-Eleches, 2008. "General Education vs. Vocational Training: Evidence from an Economy in Transition," NBER Working Papers 14155, National Bureau of Economic Research, Inc.
    20. Steven F. Koch & Jeffrey S. Racine, 2016. "Healthcare facility choice and user fee abolition: regression discontinuity in a multinomial choice setting," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 927-950, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:29:y:2010:i:4:p:603-615. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.