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The causal effect of hospital volume on health gains from hip replacement surgery

Author

Listed:
  • Laurie Rachet-Jacquet

    (Centre for Health Economics, University of York, York, UK)

  • Nils Gutacker

    (Centre for Health Economics, University of York, York, UK)

  • Luigi Siciliani

    (Department of Economics and Related Studies, University of York, York, UK)

Abstract

This study investigates the causal effect of hospital volume on health gains from hip replacement surgery in the English National Health Service. We exploit a unique dataset, which links routine hospital records and patient-reported outcome measures (PROMs) for all public hospitals in England. PROMs assess patients’ health along key dimensions of pain and mobility shortly before and six months after the surgery. We investigate whether higher hospital volume increases patient health six months post-surgery, conditioning on pre-surgery health and other patient medical and socioeconomic indicators. We address possible reverse-causality bias due to hospital demand being responsive to quality by constructing a measure of predicted hospital volumes based on a patient choice model. The results suggest that the observed volume-outcome effect in hip replacement surgery is clinically small and no longer statistically significant once we account for the endogeneity of volume.

Suggested Citation

  • Laurie Rachet-Jacquet & Nils Gutacker & Luigi Siciliani, 2019. "The causal effect of hospital volume on health gains from hip replacement surgery," Working Papers 168cherp, Centre for Health Economics, University of York.
    • Handle: RePEc:chy:respap:168cherp
    as

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    File URL: https://www.york.ac.uk/media/che/documents/papers/researchpapers/CHERP168_hospital_volume_health_gains.pdf
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    References listed on IDEAS

    as
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    More about this item

    Keywords

    quality; hospital; volumes; learning-by-doing; patient reported outcomes.;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L25 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Firm Performance

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