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Emergency care centers, hospital performance and population health
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Bhalotra, Sonia, Nunes, Letícia and Rocha, Rudi (2023) Emergency care centers, hospital performance and population health. Working Paper. Coventry: University of Warwick. Department of Economics. Warwick economics research papers series (WERPS) (1456). (Unpublished)
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Official URL: https://warwick.ac.uk/fac/soc/economics/research/w...
Abstract
Hospitals are under increasing pressure as they bear a growing burden of chronic disease while also dealing with emergency cases that do not all require hospital care. Many countries have responded by introducing alternative facilities that provide 24/7 care for basic and medium-complexity cases. Using administrative data, we investigate impacts of the opening of these intermediate facilities (UPA) in the state of Rio de Janeiro in Brazil. We find that an UPA opening in the catchment area of a hospital reduces hospital outpatient procedures and admissions and that this is associated with improved hospital performance. There is a decline in inpatient mortality, particularly mortality from the more complex conditions that hospitals are best equipped to deal with. There is no discernible change in the risk profile of cases going to hospital, and no concurrent policy changes that can account for these findings. In order to capture displacement effects, we investigate city-level population outcomes. We find that two-thirds of the decline in hospital mortality is offset by deaths in UPAs. Looking at individual death causes, we see a net decline in deaths from congestive heart failure.
Item Type: | Working or Discussion Paper (Working Paper) | ||||||||||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||||||||||
Divisions: | Faculty of Social Sciences > Economics | ||||||||||||
Library of Congress Subject Headings (LCSH): | Hospital care -- Brazil, Emergency medical services -- Brazil, Emergency medicine -- Brazil | ||||||||||||
Series Name: | Warwick economics research papers series (WERPS) | ||||||||||||
Publisher: | University of Warwick. Department of Economics | ||||||||||||
Place of Publication: | Coventry | ||||||||||||
ISSN: | 0083-7350 | ||||||||||||
Official Date: | March 2023 | ||||||||||||
Dates: |
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Number: | 1456 | ||||||||||||
Number of Pages: | 71 | ||||||||||||
Institution: | University of Warwick | ||||||||||||
Status: | Not Peer Reviewed | ||||||||||||
Publication Status: | Unpublished | ||||||||||||
Access rights to Published version: | Free Access (unspecified licence, 'bronze OA') | ||||||||||||
Description: | This paper also appears as CAGE Discussion paper 659 |
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Date of first compliant deposit: | 15 March 2023 | ||||||||||||
Date of first compliant Open Access: | 15 March 2023 | ||||||||||||
RIOXX Funder/Project Grant: |
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