Title: Does my high blood pressure improve your survival? : overall and subgroup learning curves in health
Authors : Van Gestel, Raf
Müller, Tobias
Bosmans, Johan
Published in : Health economics
Volume(Issue) : 26
Issue : 9
Pages : 1094
Pages to: 1109
Publisher / Ed. Institution : Wiley
Issue Date: 2017
License (according to publishing contract) : Licence according to publishing contract
Type of review: Peer review (Publication)
Language : English
Subjects : Lasso; TAVI; Theil-Goldberger; Transcatheter aortic valve replacement
Subject (DDC) : 362: Health and social services
Abstract: Learning curves in health are of interest for a wide range of medical disciplines, healthcare providers, and policy makers. In this paper, we distinguish between three types of learning when identifying overall learning curves: economies of scale, learning from cumulative experience, and human capital depreciation. In addition, we approach the question of how treating more patients with specific characteristics predicts provider performance. To soften collinearity problems, we explore the use of least absolute shrinkage and selection operator regression as a variable selection method and Theil-Goldberger mixed estimation to augment the available information. We use data from the Belgian Transcatheter Aorta Valve Implantation (TAVI) registry, containing information on the first 860 TAVI procedures in Belgium. We find that treating an additional TAVI patient is associated with an increase in the probability of 2-year survival by about 0.16%-points. For adverse events like renal failure and stroke, we find that an extra day between procedures is associated with an increase in the probability for these events by 0.12%-points and 0.07%-points, respectively. Furthermore, we find evidence for positive learning effects from physicians' experience with defibrillation, treating patients with hypertension, and the use of certain types of replacement valves during the TAVI procedure.
Departement: School of Management and Law
Organisational Unit: Center for Energy and Environment (CEE)
Publication type: Article in scientific Journal
DOI : 10.1002/hec.3505
ISSN: 1057-9230
1099-1050
URI: https://digitalcollection.zhaw.ch/handle/11475/9538
Appears in Collections:Publikationen School of Management and Law

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