The Review of Economics and Statistics
We study how emergency department (ED) doctors respond to incentives to reduce wait times. We use bunching techniques to study an English policy that imposed strong incentives to treat patients within four hours. The policy reduced time spent in the ED by 21 minutes for affected patients yet caused doctors to increase treatment intensity and admit more patients. We find a striking 14% reduction in mortality. Analysis of patient severity and hospital crowding strongly suggests it is the wait time reduction that saves lives. We conclude that, despite distorting medical decisions, constraining ED doctors can induce cost-effective reductions in mortality.
I completed a PhD at UCL in 2020. My work examines the drivers of variation in the quantity and quality of healthcare provided to different patients.
Research Associate Cornell University
Thomas is a Research Associate of the IFS and an Assistant Professor in the Department of Policy Analysis and Management at the Cornell University.
Research Associate Massachusetts Institute of Technology
Jonathan is a Research Associate at the IFS and the Ford Professor of Economics at the Massachusetts Institute of Technology.
Journal article details
- The President and Fellows of Harvard College and the Massachusetts Institute of Technology
- Volume 105, Issue 1, January 2023, pages 1-19
J, Gruber and T, Hoe and G, Stoye. (2023). 'Saving lives by tying hands: The unexpected effects of constraining health care providers' 105(1/2023), pp.1–19.
More from IFS
Understand this issue
28 August 2023
17 November 2023
14 September 2023
31 October 2023
24 June 2023
Dementia incidence trend in England and Wales, 2002–19, and projection for dementia burden to 2040: analysis of data from the English Longitudinal Study of Ageing
30 October 2023
29 September 2023