TY  - JOUR
AU  - Chandra,Amitabh
AU  - Staiger,Douglas
TI  - Testing a Roy Model with Productivity Spillovers: Evidence from the Treatment of Heart Attacks
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 10811
PY  - 2004
Y2  - October 2004
UR  - http://www.nber.org/papers/w10811
L1  - http://www.nber.org/papers/w10811.pdf
N1  - Author contact info:
Amitabh Chandra
John F. Kennedy School of Government
Harvard University
79 JFK Street
Cambridge, MA 02138
Tel: 617/496-7356
E-Mail: amitabh_chandra@harvard.edu

Douglas O. Staiger
Dartmouth College
Department of Economics
HB6106, 301 Rockefeller Hall
Hanover, NH 03755-3514
Tel: 603/646-2979
Fax: 603/646-2122
E-Mail: douglas.staiger@dartmouth.edu
AB  - Productivity spillovers are often cited as a reason for geographic specialization in production. A large literature in medicine documents specialization across areas in the use of surgical treatments, which is unrelated to patient outcomes. We show that a simple Roy model of patient treatment choice with productivity spillovers can generate these facts. Our model predicts that high-use areas will have higher returns to surgery, better outcomes among patients most appropriate for surgery, and worse outcomes among patients least appropriate for surgery. We find strong empirical support for these and other predictions of the model, and decisively reject alternative explanations commonly proposed to explain geographic variation in medical care.
ER  -