000			02702cam a22003257 4500
001			w26618
003			NBER
005			20211020103914.0
006			m o d
007			cr cnu||||||||
008			210910s2020 mau fo 000 0 eng d
100	1		_aCurrie, Janet. _98688
245	1	0	_aDoes the Marginal Hospitalization Save Lives? The Case of Respiratory Admissions for the Elderly / _cJanet Currie, David Slusky.
260			_aCambridge, Mass. _bNational Bureau of Economic Research _c2020.
300			_a1 online resource: _billustrations (black and white);
490	1		_aNBER working paper series _vno. w26618
500			_aJanuary 2020.
520	3		_aSome commentators estimate that up to a third of U.S. medical spending may be wasted. This study focuses on the decision to hospitalize elderly Medicare patients who present at the emergency room (ER) with respiratory conditions. Failing to hospitalize sick patients could have dire consequences. However, in addition to generating higher costs, unnecessary hospitalization puts patients at risk of hospital acquired conditions and disrupts their lives. We use variation in the patient's nearest hospital's propensity to admit patients with similar observable characteristics as an instrument for the admission decision. While OLS estimates suggest that admitted patients are more likely to die, when we instrument for patient admission we find that the marginal hospital admission increases the number of hospital days by seven days and increases charges by $42,000 but has no effect on the risk of death in the course of the next year. The marginal hospitalization also reduces the risk of another emergency department visit in the next 30 days but increases outpatient visits over the same time horizon with no overall impact on charges. Longer term effects also include increased outpatient visits but effects on patient costs and health outcomes over the next year are minimal. Overall, these results lend support to the argument that in many cases the marginal hospitalization is unnecessary.
530			_aHardcopy version available to institutional subscribers
538			_aSystem requirements: Adobe [Acrobat] Reader required for PDF files.
538			_aMode of access: World Wide Web.
588	0		_aPrint version record
690		7	_aI1 - Health _2Journal of Economic Literature class.
700	1		_aSlusky, David.
710	2		_aNational Bureau of Economic Research.
830		0	_aWorking Paper Series (National Bureau of Economic Research) _vno. w26618.
856	4	0	_uhttps://www.nber.org/papers/w26618
856			_yAcceso en línea al DOI _uhttp://dx.doi.org/10.3386/w26618
942			_2ddc _cW-PAPER
999			_c321504 _d280066