TY  - JOUR
AU  - Doyle,Joseph J., Jr.
TI  - Returns to Local-Area Health Care Spending: Using Health Shocks to Patients Far From Home 
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 13301
PY  - 2007
Y2  - August 2007
UR  - http://www.nber.org/papers/w13301
L1  - http://www.nber.org/papers/w13301.pdf
N1  - Author contact info:
Joseph J. Doyle, Jr.
MIT Sloan School of Management
50 Memorial Drive
E52-447
Cambridge, MA 02142
Tel: 617/452-3761
Fax: 617/258-6855
E-Mail: jjdoyle@mit.edu
AB  - Health care spending varies widely across markets, yet there is little evidence that higher spending translates into better health outcomes, possibly due to endogeneity bias.  The main innovation in this paper compares outcomes of patients who are exposed to different health care systems that were not designed for them:  patients who are far from home when a health emergency strikes.  The universe of emergencies in Florida from 1996-2003 is considered, and visitors who become ill in high-spending areas have significantly lower mortality rates compared to similar visitors in lower-spending areas. The results are robust across different types of patients and within groups of destinations that appear to be close demand substitutes.
ER  -