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Does advanced medical technology encourage hospitalist use and their direct employment by hospitals?

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  • Guy David
  • Lorens A. Helmchen
  • Robert A. Henderson

Abstract

In the United States, inpatient medical care increasingly encompasses the use of expensive medical technology and, at the same time, is coordinated and supervised more and more by a rapidly growing number of inpatient‐dedicated physicians (hospitalists). In the production of inpatient care services, Hospitalist services can be viewed as complementary to sophisticated and expensive medical equipment in the provision of inpatient medical care. We investigate the causal relationship between a hospital's access to three types of sophisticated diagnostic and therapeutic medical equipment – intensity‐modulated radiation therapy, gamma knife, and multi‐slice computed tomography – and its likelihood of using hospitalists. To rule out omitted variables bias and reverse causality, we use technology‐specific Certificate of Need regulation to predict technology use. We find a strong positive association, yet no causal link between access to medical technology and hospitalist use. We also study the choice of employment modality among hospitals that use hospitalists, and find that access to expensive medical technology reduces the hospital's propensity to employ hospitalists directly. Copyright © 2008 John Wiley & Sons, Ltd.

Suggested Citation

  • Guy David & Lorens A. Helmchen & Robert A. Henderson, 2009. "Does advanced medical technology encourage hospitalist use and their direct employment by hospitals?," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 237-247, February.
  • Handle: RePEc:wly:hlthec:v:18:y:2009:i:2:p:237-247
    DOI: 10.1002/hec.1360
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    References listed on IDEAS

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    1. Noether, Monica, 1988. "Competition among hospitals," Journal of Health Economics, Elsevier, vol. 7(3), pages 259-284, September.
    2. Vivian Ho, 2006. "Does certificate of need affect cardiac outcomes and costs?," International Journal of Health Economics and Management, Springer, vol. 6(4), pages 300-324, December.
    3. Richard K. Crump & V. Joseph Hotz & Guido W. Imbens & Oscar A. Mitnik, 2006. "Moving the Goalposts: Addressing Limited Overlap in the Estimation of Average Treatment Effects by Changing the Estimand," NBER Technical Working Papers 0330, National Bureau of Economic Research, Inc.
    4. Heckman, James J, 1978. "Dummy Endogenous Variables in a Simultaneous Equation System," Econometrica, Econometric Society, vol. 46(4), pages 931-959, July.
    5. Guy David & Lorens A. Helmchen, 2007. "The Choice of Employment Arrangement in the Market for Hospitalist Services," Southern Economic Journal, John Wiley & Sons, vol. 73(3), pages 604-622, January.
    6. Lanning, Joyce A & Morrisey, Michael A & Ohsfeldt, Robert L, 1991. "Endogenous Hospital Regulation and Its Effects on Hospital and Non-hospital Expenditures," Journal of Regulatory Economics, Springer, vol. 3(2), pages 137-154, June.
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    Cited by:

    1. Maynou, L. & McGuire, A. & Serra-Sastre, V., 2019. "Exploring the Impact of New Medical Technology on Workforce Planning," Working Papers 19/07, Department of Economics, City University London.
    2. Gary Ferrier & Hervé Leleu & James Moises & Vivian Valdmanis, 2013. "The Focus Efficiency of U.S. Hospitals," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 41(3), pages 241-263, September.
    3. Joon Mahn Lee & Rahul Kapoor, 2017. "Complementarities and Coordination: Implications for Governance Mode and Performance of Multiproduct Firms," Organization Science, INFORMS, vol. 28(5), pages 931-946, October.
    4. Maynou, Laia & McGuire, Alistair & Serra-Sastre, Victoria, 2024. "What happens when the tasks dry up? Exploring the impact of medical technology on workforce planning," LSE Research Online Documents on Economics 124065, London School of Economics and Political Science, LSE Library.
    5. Gary D. Ferrier & Hervé Leleu & James Moises & Vivian Valdmanis, 2009. "The Size and Service Offering Efficiencies of U.S. Hospitals," Working Papers 2009-ECO-09, IESEG School of Management.

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