Ashtari Tafti, Elena;
(2023)
Essays in the Economics of Healthcare.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
This dissertation examines three phenomena, that are prevalent in healthcare, and their consequences for patient health outcomes. The focus of Chapter 2 is the adoption and diffusion of robots in England for the surgical treatment of prostate cancer patients in the National Health Service (NHS). Exploiting quasi-random variation in the geographic allocation of robots, Chapter \ref{chapterlabel2} shows that robots shorten patients’ length of stay and decrease the incidence of adverse events from surgery, but their effects are heterogeneous and significantly depend on surgeons’ skills. High-skilled surgeons benefit the least from using the technology, while lower-skilled surgeons appear to gain the most from it. Chapter 3 studies the impact of hospital mergers on the quality of clinical care. Using the universe of hospital medical records in England, it examines all public hospital mergers after the introduction of hospital choice in 2006. There were 159 hospital sites involved in mergers over our sample period, comprising 13 transactions. Using an event study framework, this Chapter finds that mergers have immediate and persistent negative impacts on clinical quality. Chapter 4 uses a unique source of information, Real-Time Location System (RTLS) Data, to study the effect of contact time on patient health outcomes. RTLS allows to perfectly observe the amount of time nurses spend with patients in the hospital. This Chapter exploits the granularity of this data to estimate a causal impact of contact time on patient outcomes by decomposing contact time into an endogenous and plausibly exogenous component and shows that direct contact between nurses and patients significantly reduces in-hospital mortality and accidents.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Essays in the Economics of Healthcare |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2023. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL SLASH UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS > Dept of Economics |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10181909 |
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