August 8, 2017
We find that where a doctor received his/her initial training matters in terms of predicting how likely they are to prescribe opioids: physicians trained at the lowest ranked US medical schools prescribe nearly three times as many opioids per year as physicians trained at the top medical school. This striking inverse relationship reflects two factors: (1) physicians from lower ranked medical schools are more likely to write any opioid prescriptions; and (2) conditional on being an opioid prescriber, physicians for lower ranked medical schools write more opioid prescriptions on average. This prescribing gradient is particularly pronounced among GPs. Our results demonstrate that if all GPs prescribed like those from the top ranked school, we would
have had 56.5% fewer opioid prescriptions and 8.5% fewer deaths over the period 2006 to 2014.
Full text: http://www.nber.org/papers/w23645.pdf
February 7, 2017
The recent fall of labor’s share of GDP in numerous countries is well-documented, but its causes are poorly understood. We sketch a “superstar firm” model where industries are increasingly characterized by “winner take most” competition, leading a small number of highly profitable (and low labor share) firms to command growing market share. Building on Autor et al. (2017), we evaluate and confirm two core claims of the superstar firm hypothesis: the concentration of sales among firms within industries has risen across much of the private sector; and industries with larger increases in concentration exhibit a larger decline in labor’s share.
Source: Concentrating on the Fall of the Labor Share by David H. Autor, David Dorn, Lawrence F. Katz, Christina Patterson, John Van Reenen :: SSRN
January 23, 2017
The process of privatisation of health care has followed different patterns and some health care systems have preferred to create a mixed market where public organisations compete alongside private ones. The evidence on their performance is mixed. In this article we argue that public hospitals have different objectives than private ones, faces different constraints and are perceived differently from the patients. For this reason we model the market for hospital care as Salop circle with a centre where the public hospital is at the centre and private providers are along the circle. We show that, depending on the difference in the productivity advantage, mixed market may outperform both the benchmark (one public hospital at the centre) and private competition (N private providers competing along the circle).
Our model offers several policy implications: the process of privatisation may lead to cost reduction in the provision of health care, but it reduces the altruistic motivation of the staff. In health care this may lead to increased cost as concerns quality. The second important consideration relates to the perception that patients have of hospital pursuing different objectives, another aspect that should be taken into account in privatisation. Finally we show that in a mixed market it may be optimal to allow the public hospital to interpret its budget as soft; this mechanism may in fact allow to reduce the total health are bill.
Source: Oligopolistic Competition for the Provision of Hospital Care by Laura Levaggi, Rosella Levaggi :: SSRN
December 5, 2016
We still know little about what motivates the informal care arrangements provided in old age. The introduction of demand-side subsidies such as unconditional caregiving allowances (cash benefits designed either to incentivize the provision of informal care, or compensate for the loss of employment of informal caregivers) provide us with an opportunity to gain a further understanding of the matter. In this paper we exploit a quasi-natural experiment to identify the effects of the inception in 2007 (and its reduction in 2012) of a universal caregiving allowance on both the supply of informal care, and subsequent intergenerational transfer flows. We find evidence of a 30% rise in informal caregiving after the subsidy, and an increase (reduction) in downstream (upstream) intergenerational transfers of 29% (and 15%). Estimates were heterogeneous by income and wealth quantiles. Consistently, the effects were attenuated by a subsequent policy intervention; the reduction of the subsidy amidst austerity cuts in 2012.
Source: Thinking of Incentivizing Care? The Effect of Demand Subsidies on Informal Caregiving and Intergenerational Transfers by Joan Costa-Font, Sergi Jimenez-Martin, Cristina Vilaplana :: SSRN
November 14, 2016
Retail clinics have become a popular choice for routine aliments and quick primary care treatment, but they may not be reducing visits to emergency departments, according to a new analysis.
There’s little question Americans have taken to the concept of retail medicine as CVS Health CVS +1.21%, Walgreens, Walmart and grocery store chains like Kroger have opened thousands of clinics as a primary care option. CVS now has more than 1,100 MinuteClinics in 33 states . But RAND Corp. researchers looking at the early days of retail clinic growth indicates they might not be changing patient behaviors when it comes to using more expensive hospital emergency rooms.
Source: Despite Walgreens And CVS Clinics, Hospital ERs Still Used For Routine Care
November 7, 2016
This review summarizes the theoretical and empirical literature on the importance of linkages between universities and industries in the development of commercial applications of biotechnology. These linkages range from formal agreements, such as patent licenses and research alliances, to informal collaborations, such as joint research, copublication, and consulting. Because biotechnology involves a new research method, the tacit knowledge embedded in it became critical to its commercialization. Specifically, it requires the direct involvement of star scientists who have this tacit knowledge and are well remunerated for it. This process is facilitated by the passage of the Bayh–Dole Act, which allows universities to retain ownership of crucial patents and provides incentives to the star scientists to cooperate in development and commercialization. Over time, a complex web of collaborations and alliances has evolved in therapeutic, diagnostic, and pharmaceutical biotechnology, whereas extensive consolidation has occurred in agricultural biotechnology.
Source: University–Industry Linkages in the Support of Biotechnology Discoveries by Richard A. Jensen :: SSRN
April 24, 2015
To learn more, read Tom Stossel’s “Pharmaphobia,” on how rules against pharmaceutical marketing and industry-sponsored research are undermining innovation.
via Pharmaphobia – AEI.