Every Monday our authors provide a round-up of some of the most recently published peer reviewed articles from the field. We don’t cover everything, or even what’s most important – just a few papers that have interested the author. Visit our Resources page for links to more journals or follow the HealthEconBot. If you’d like to write one of our weekly journal round-ups, get in touch.
Choice of hospital: Which type of quality matters? Journal of Health Economics. [PubMed] Published December 2016.
We have covered a number of papers over the last few months on the relationship between hospital quality and patient choice. In one post, we discussed a paper that analysed the effect of pro-choice reforms on patient choice and outcomes in the English NHS, but argued that their measure of quality, risk-adjusted mortality rates, were not a good indicator or proxy. This article looks at the effect of quality on patient choice for patients undergoing a hip replacement. Quality is captured using the Oxford Hip Score (OHS), a hip replacement specific instrument, which measures overall health status for these patients. They find that the OHS score is only weakly correlated with readmission and mortality rates, and that hospital demand is highly elastic with respect to average OHS gain, but not mortality and readmission rates. This suggests patient respond to health gain from treatment, at least for health gain; there remains a question about how patient find out about hospital quality, although another recently featured paper may shed light on this.
Moving to Opportunity or Isolation? Network Effects of a Randomized Housing Lottery in Urban India. American Economic Review: Applied Economics. [NBER, RePEc] Forthcoming.
The rapid pace of urbanisation in low and middle income countries has led to the growth of slums. In response, governments have tried to implement new programs to improve the health and welfare of those living in slums. In a recent post, we documented the difficulties in the measurement of the health of people who live in slums and the evaluation of interventions. Part of the difficulty with measuring neighbourhood effects in a scientific sense is that randomisation is typically not possible. One notable example was the Moving to Opportunity experiements in the US. This article reports the long term outcomes from an Indian equivalent where a lottery was used to allocate new, improved housing built on the periphery of the slum. Interestingly, the experiment was not a success: 34% of the winners did not move, and 32% eventually exited the experiment. Part of this failure was the breakdown of community – many people became lonely or isolated. These findings clearly have implications for the design of slum upgrading programs and strategies to improve public health.