Inefficiency in the U.S. health care system has often been characterized as "flat of the curve" spending providing little or no incremental value. In this paper, we draw on macroeconomic models of diffusion and productivity to better explain the empirical patterns of outcome improvements in...

There is little empirical evidence to explain why disability declined among the elderly over the past 20 years. In this paper, we explore the role of improved medical care for cardiovascular disease on health status improvements over time. We show that the incidence of cardiovascular disease...

Variation in technology adoption is a key driver of differences in productivity. Previous studies sought to explain variations in technology adoption by heterogeneity in profitability, costs of adoption, or other factors. Less is known about how adoption is affected by bias in the perceived...

We use machine learning to better characterize low-value health care and the decisions that produce it. We focus on costly tests, specifically for heart attack (acute coronary syndromes). A test is only useful if it yields new information, so efficient testing is grounded in accurate prediction...

We analyze whether decreased emergency department access (measured by increased driving time to the nearest ED) results in adverse patient outcomes or changes in the patient health profile for patients suffering from acute myocardial infarction. Data sources include 100% Medicare Provider...

Productivity spillovers are often cited as a reason for geographic specialization in production. A large literature in medicine documents specialization across areas in the use of surgical treatments, which is unrelated to patient outcomes. We show that a simple Roy model of patient treatment...

Managed care may affect medical treatments for non-managed-care patients if it alters local market structure or physician behavior. We investigate whether higher levels of overall managed care market share are associated with greater use of recommended therapies for fee-for-service patients with...

We develop a conceptual framework and empirically investigate how a permanent emergency department (ED) closure affects patients with acute myocardial infarction (AMI). We first document that large increases in driving time to closest ED are more likely to happen in low-income communities and...

When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), the provider on duty must quickly decide how aggressively the patient should be treated. Using Florida data on all such patients from 1992-2014, we decompose practice style into two components: The provider's...

Percutaneous coronary intervention facility openings may have differential effects on treatment and health outcomes for Black versus White patients in residentially segregated versus integrated communities. This study looked at changes in patient treatment and health outcomes (same-day PCI, PCI...