This paper examines the causal effect of volume on outcome on the example of patients with a hip fracture. We use an instrumental variable approach and consider both the practice-makes-perfect and selective-referral hypothesis as well as unobserved patient heterogeneity. Our results indicate...

Although learning-by-doing is believed to be an important source of productivity growth there is limited evidence that production volume affects productivity in a causal sense. We document evidence of learning-by-doing in a high-skill profession where stakes are high; advanced cancer surgery....

We investigate the welfare impact of parallel imports using a large panel data set containing monthly information on sales, ex-factory prices, and further product characteristics for all 700 antidiabetic drugs sold in Germany between 2004 and 2010. We estimate a two-stage nested logit model of...

This paper seeks to understand the impact of the Medicare Rural Hospital Flexi- bility (Flex) Program on rural resident hospital choice and welfare. The Flex program created a new class of hospital, the Critical Access Hospital (CAH), which receives more generous reimbursement in return for...

Since 2003/2004, German hospitals are reimbursed based on a prospective payment scheme (diagnosis related groups, DRGs). Patient classification in neonatology is based inter alia on birth weight, with substantial discontinuities in reimbursement at the relevant thresholds. These discontinuities...

This paper studies externalities of nationally determined cost-sharing systems, in particular coinsurance rates (patients pay a percentage of the price), under pharmaceutical parallel trade, i.e. trade outside the manufacturer's authorized distribution channel, in a two-country model with a...

This paper evaluates the impact of reference pricing on prices and co-payments in the (German) market for off-patent pharmaceuticals. We present a theoretical model with price-sensitive and loyal consumers that shows that a decrease in the reference price affects the consumers' co-payments in a...

Based on the Canadian National Population Health Survey we estimate the effects of individ-ual sports and exercise on individual labor market outcomes. The data covers the period from 1994 to 2008. It is longitudinal and rich in life-style, health, and physical activity in-formation. Exploiting...

Excessive alcohol consumption among youth and young adults is a major public health concern. On March 1, 2010 the German federal state of Baden-W rttemberg banned the sale of alcoholic beverages between 10pm and 5am in off-premise outlets (e.g. kiosks, petrol stations, supermarkets). We use rich...

We investigate two determinants of the price sensitivity of health plan demand among retirees in the German social health insurance (SHI): the size of the choice set and the salience of premium differences. We use variation in the choice set over time and between regions, and an increase in the...