Fernandez, Jose (2006): Evaluating the Effect of a Policy Change to Hospital Productivity: 80 Hours Work Restriction on Medical Residents.
Download (150kB) | Preview
This paper uses a two-year panel dataset on hospitals from the American Hospital Association (AHA) to evaluate the effect a policy change has on the marginal product of medical residents. A weighted 2SLS approach is used to estimate a semi-parametric production function. A policy restricting medical residents to work no more than 80 hours a week is found to result in a net loss of 14 inpatient days per resident annually, which is not statistically different from zero. In addition, the model presented in this paper performs better than past models when estimating first-order effects of inputs in the hospital production function.
|Item Type:||MPRA Paper|
|Original Title:||Evaluating the Effect of a Policy Change to Hospital Productivity: 80 Hours Work Restriction on Medical Residents|
|Keywords:||work hour reform; medical residents; hospital production; 80 hour work week; semi parametric estimation|
|Subjects:||I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets
C - Mathematical and Quantitative Methods > C1 - Econometric and Statistical Methods and Methodology: General > C14 - Semiparametric and Nonparametric Methods: General
D - Microeconomics > D2 - Production and Organizations > D24 - Production ; Cost ; Capital ; Capital, Total Factor, and Multifactor Productivity ; Capacity
|Depositing User:||Jose Fernandez|
|Date Deposited:||07. May 2008 04:36|
|Last Modified:||17. Mar 2015 06:55|
American Hospital Association, “Special Report 4: The Medicare Case Mix Index.” Medical Payment: Cost-per-Case Management (Chicago, Aug. 1983)
Brasseur, Carine and Bart Cockx, “The demand for physician services: Evidence from a natural experiment,” The Journal of Health Economics, Vol. 22 (2003), 881-913
Conigliaro, Joseph, et. al., “Internal Medicine Housestaff and Attending Physician Perceptions of the Impact of the New York State Section 405 Regulations on Working Conditions and Supervision of Residents in Two Training Programs,” The Journal of General Internal Medicine, Vol. 8 (September 1993), 502-707
Daugherty, Steven R., DeWitt C. Baldwin, Jr, and Beverly D. Rowley, “Learning, Satisfaction, and Mistreatment During Medical Internship: A National Survey of Working Conditions,” JAMA Vol 279, No. 15 (April 1998), 1194-1199
Jensen, Gail A. and Michael A. Morrisey, “The Role of Physicians in Hospital Production,” The Review of Economics and Statistics, Vol. 68, Issue 3, (Aug. 1986), 432-442
Ichimura, H. “Semiparametric Least Squares (SLS) and Weighted SLS Estimation of Single-Index Models," Journal of Econometrics, 58, June 1993, 71-120.
Lave, Judith R. and Lester B. Lave, “Hospital Cost Functions,” The American Economic Review, Vol. 60, Issue 3 (June 1970), 379-395
Nicholson, Sean, "Physician Specialty Choice Under Uncertainty." Journal of Labor Economics 2002; 20(4): 816-847
Nicholson, Sean and Nicholas S. Souleles, "Physician Income Expectations and Specialty Choice." NBER Working Paper 8536 (2003)
Nicholson, Sean, "Barriers to Entering Medical Specialties." NBER Working Paper 9649 (2003)
Olley, S. and A. Pakes, “The Dynamics of Productivity in the Telecommunications Equipment Industry,” Econometrica, 64(6), 1996, 1263-1297
Pagan, Adrian and Aman Ullah, Nonparametric Econometrics, Cambridge University Press, 1999.
Powell, James L., “Estimation of Semiparametric Models,” Draft, September 1992
Reinhardt, U., “A Production Function for Physician Services,” The Review of Economics and Statistics, Vol. 54, Issue 1 (Feb. 1972), 55-66
Sharfstein, JM. “Asleep on the Job,” The New Republic, June 21, 1999
Sloan, Frank A., and Joseph Valvona, “Identifying the Cost of Graduate Medical Education,” paper presented at the Health Policy Symposium, Providing and Paying for Medical Education: Past, Present, and Future,” Vanderbilt University, May 3-4, 1985.
Williamson and Feyer, “Moderate Sleep Deprivation Produces Impairment in Cognitive and Motor Performance Equivalent to Legally Prescribed Levels of Alcohol Intoxication.” Occup Environ Med. 2000 Oct; 57(10): 649-655