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Jonathan Gruber
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Journal Articles
Publisher: Journals Gateway
The Review of Economics and Statistics (2023) 105 (1): 1–19.
Published: 06 January 2023
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We study how emergency department (ED) doctors respond to incentives to reduce wait times. We use bunching techniques to study an English policy that imposed strong incentives to treat patients within four hours. The policy reduced time spent in the ED by 21 minutes for affected patients yet caused doctors to increase treatment intensity and admit more patients. We find a striking 14% reduction in mortality. Analysis of patient severity and hospital crowding strongly suggests it is the wait time reduction that saves lives. We conclude that, despite distorting medical decisions, constraining ED doctors can induce cost-effective reductions in mortality.
Includes: Supplementary data
Journal Articles
Publisher: Journals Gateway
The Review of Economics and Statistics (2019) 101 (5): 841–852.
Published: 01 December 2019
FIGURES
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Hospital quality measures are crucial to a key idea behind health care payment reforms: “paying for quality” instead of quantity. Nevertheless, such measures face major criticisms largely over the potential failure of risk adjustment to overcome endogeneity concerns when ranking hospitals. In this paper, we test whether patients treated at hospitals that score higher on commonly used quality measures have better health outcomes in terms of rehospitalization and mortality. To compare similar patients across hospitals in the same market, we exploit ambulance company preferences as an instrument for hospital choice. We find that a variety of measures that insurers use to measure provider quality are successful: choosing a high-quality hospital compared to a low-quality hospital results in 10% to 15% better outcomes.
Includes: Supplementary data
Journal Articles
Publisher: Journals Gateway
The Review of Economics and Statistics (2017) 99 (1): 32–39.
Published: 01 March 2017
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When choices are made from ordered lists, individuals can exhibit biases toward selecting certain options as a result of the ordering. We examine this phenomenon in the context of consumer response to the ordering of economics papers in an e-mail announcement issued by the NBER. We show that despite the effectively random list placement, papers listed first each week are about 30% more likely to be viewed, downloaded, and subsequently cited. We suggest that a model of “skimming” behavior, where individuals focus on the first few papers in the list due to time constraints, would be most consistent with our findings.
Journal Articles
Publisher: Journals Gateway
The Review of Economics and Statistics (2009) 91 (1): 124–136.
Published: 01 February 2009
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Abortion legalization in the early 1970s led to dramatic changes in fertility. Some research has suggested that it altered cohort outcomes, but this literature has been limited and controversial. In this paper, we provide a framework for understanding selection mechanisms and use that framework to both address inconsistent past methodological approaches and provide evidence on the long-run impact on cohort characteristics. Our results indicate that lower-cost abortion brought about by legalization altered young adult outcomes through selection. In particular, it increased likelihood of college graduation, lower rates of welfare use, and lower odds of being a single parent.
Journal Articles
Publisher: Journals Gateway
The Review of Economics and Statistics (2008) 90 (4): 754–764.
Published: 01 November 2008
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A long-standing assumption among economists is that nursing home quality is common across Medicaid and private-pay patients within a shared facility. However, there has been only limited empirical work addressing this issue. Using a unique individual-level panel of residents of nursing homes from seven states, we exploit both within-facility and within-person variation in payer source and quality to examine this issue. We also test the robustness of these results across states with different Medicaid and private-pay rate differentials. Across various identification strategies, our results are consistent with the assumption of common quality across Medicaid and private-paying patients within facilities.
Journal Articles
Publisher: Journals Gateway
The Review of Economics and Statistics (2007) 89 (2): 234–246.
Published: 01 May 2007
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A critical question for Social Security policy is how program incentives affect retirement behavior. We use the Health and Retirement Survey (HRS) to examine the impact of Social Security incentives on male retirement. We implement forward-looking models whereby individuals consider the incentives to work in all future years. We find that forward-looking incentive measures for Social Security are significant determinants of retirement. We also find that private pension incentives have roughly similar effects. Our findings suggest that Social Security policies that increase the incentives to work at older ages can significantly reduce the labor force exit rate of older workers.