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

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  • Douglas Almond
  • Joseph J. Doyle
  • Amanda E. Kowalski
  • Heidi Williams

Abstract

In , 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. Copyright 2011, Oxford University Press.

Suggested Citation

  • Douglas Almond & Joseph J. Doyle & Amanda E. Kowalski & Heidi Williams, 2011. "The Role of Hospital Heterogeneity in Measuring Marginal Returns to Medical Care: A Reply to Barreca, Guldi, Lindo, and Waddell," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 126(4), pages 2125-2131.
    • Handle: RePEc:oup:qjecon:v:126:y:2011:i:4:p:2125-2131
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    File URL: http://hdl.handle.net/10.1093/qje/qjr037
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    Citations

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    Cited by:

    1. Reif, Simon & Wichert, Sebastian & Wuppermann, Amelie, 2018. "Is it good to be too light? Birth weight thresholds in hospital reimbursement systems," Journal of Health Economics, Elsevier, vol. 59(C), pages 1-25.
    2. repec:zbw:itse23:277968 is not listed on IDEAS
    3. Guiffard, Jean-Baptiste, 2024. "Valuing the virtual: The impact of fiber to the home on property prices in France," Telecommunications Policy, Elsevier, vol. 48(4).
    4. Otávio Bartalotti & Quentin Brummet & Steven Dieterle, 2021. "A Correction for Regression Discontinuity Designs With Group-Specific Mismeasurement of the Running Variable," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 39(3), pages 833-848, July.
    5. Zhuan Pei & Yi Shen, 2017. "The Devil is in the Tails: Regression Discontinuity Design with Measurement Error in the Assignment Variable," Advances in Econometrics, in: Regression Discontinuity Designs, volume 38, pages 455-502, Emerald Group Publishing Limited.
    6. Yingying Dong & Michal Kolesár, 2023. "When Can We Ignore Measurement Error in the Running Variable?," Working Papers 2022-13, Princeton University. Economics Department..
    7. Jin-young Choi & Myoung-jae Lee, 2017. "Regression discontinuity: review with extensions," Statistical Papers, Springer, vol. 58(4), pages 1217-1246, December.
    8. Petek, Nathan, 2022. "The marginal benefit of hospitals: Evidence from the effect of entry and exit on utilization and mortality rates," Journal of Health Economics, Elsevier, vol. 86(C).
    9. Yingying Dong & Michal Kolesár, 2023. "When can we ignore measurement error in the running variable?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 38(5), pages 735-750, August.

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    1. Estimating Marginal Returns to Medical Care: Evidence from At-risk Newborns (QJE 2010) in ReplicationWiki

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