Instrumental variables: Can I use patient level IVs to correct for endogeneity in patient characteristics?

Does a treatment improve patient health?  Does a policy intervention improve quality of life?  Does more education increase income?  These are fundamental questions that are difficult to answer with standard observational approaches.  The reason?  Selection bias.  Patients who are sick take medicine; patients who are sicker may take more medicine.  Thus, one could observe that…

Family knows best

Is caregiving by family members superior to paid home health caregiving? According to a paper by Coe et al. (2019), the answer is ‘yes’. We find that some family involvement in home‐based care significantly decreases health‐care utilization: lower likelihood of emergency room use, Medicaid‐financed inpatient days, any Medicaid hospital expenditures, and fewer months with Medicaid‐paid…

Trends in hospital consolidation

The National Institute for Health Care Management (NIHCM) has some nice slides describing trends in hospital consolidation. First, we see a trend of increased hospitalizations over time. Further, these mergers are not small. In 49% of cases, the acquired (i.e., smaller) hospital has revenue of >$100m and in 19% of cases the acquired hospitals has…