Healthcare

We document that interactions with manipulated Clinical Decision Support (CDS) systems can induce not only short-term but also long-term changes in physicians' opioid prescribing behavior. Physicians in our sample adopted electronic health record software from a list of federally certified vendors in 2011. Between 2016 and Spring 2019, one vendor secretly embedded a biased CDS function designed to promote extended-release opioid sales.

Merit-based recruitment and higher pay in Chile’s public hospitals attracted better-trained managers – leading to lower mortality rates and improved healthcare performance.

We study whether the quality of managers can affect public service provision in the context of public health. Using novel data from public hospitals in Chile, we show how the introduction of a competitive recruitment system and better pay for public hospital CEOs reduced hospital mortality by 8 percent. The effect is not explained by a change in patient composition. We find that the policy changed the pool of CEOs by displacing doctors with no management training in favor of CEOs who had studied management.

We study the aggregate and heterogeneous effects of a front-of-package labeling policy implemented in Chile. We find that consumers reduced their sugar and caloric intake by 9% and 6%, respectively. On the demand side, labels prompt consumers to substitute within categories rather than switching between categories. Within-category responses are more pronounced when labels provide new information. On the supply side, we observe bunching at regulatory thresholds, with substantial heterogeneity across categories, consistent with differing costs of product reformulation.

Occupational licensing is a widespread quality regulation that increases the quality of labor but reduces its quantity. We provide a framework to empirically quantify this trade-off and apply it to physician licensing, where both quality and access to care are critical concerns. Using quasi-exogenous variation driven mostly by a recent and unprecedented migration of physicians to Chile, we show that more physicians improve access and patient outcomes in tertiary care, including mortality.

This study implemented and evaluated a prediction-driven nurse staffing framework in a large adult emergency department. The framework leveraged a two-stage prediction model that forecasted patient volume and guided staffing decisions. Using a pre-post study design, we compared patient throughput (measured by door-to-evaluation time, active treatment time, boarding time, length of stay, and left-without-being-seen rate) and cost outcomes (measured as hourly nurse staffing costs) before and after implementation.

We investigate whether the diseases for which there was more biomedical innovation had larger 1999–2019 reductions in premature mortality. Biomedical innovation related to a disease is measured by the change in the mean vintage of descriptors of PubMed articles about the disease. We analyze data on 286 million descriptors of 27 million articles about over 800 diseases. Premature mortality from a disease is significantly inversely related to the lagged vintage of descriptors of articles about the disease.