Is HIT a hit? The impact of health information technology on inpatient hospital outcomes

In an effort to eliminate inefficiencies in the US health care sector, policymakers have made a concerted effort to encourage hospitals and physicians to adopt health information technology (HIT) systems. Using a unique data set on HIT adoption and health outcomes in New York State, we conduct a hospital-level analysis identifying the impact of adopting HIT on inpatient outcomes (rates of adverse drug events and severity-adjusted mortality). Unlike previous studies, the patient population is not restricted to Medicare patients, but covers all ages and insurance types. After controlling for unobserved hospital quality and endogenous HIT adoption, our results suggest that a hospital’s severity-adjusted mortality decreases by 0.3 percentage points. When restricted to the Medicare patients, we find HIT adoption lowers a hospital’s severity-adjusted mortality rate by 0.5 percentage points. We find HIT to have no significant effect on the rate of ADEs.     

Can corruption encourage clean technology transfer?

We study the impact of environmental regulation on the transfer of a clean technology where bureaucrats are needed for government intervention. In the absence of corruption, when environmental taxes are low, a technology transfer always takes place and it increases total outputs, but may lead to higher pollution levels. However, when corruption is possible, a firm with a dirty technology may choose to bribe a corruptible bureaucrat who will underreport the actual level of emissions, thereby hindering the transfer of clean technology. We show that a less strict anticorruption policy may lead to more bribing, but encourage technology transfers. Moreover, an environment-oriented government would set a deterrent environmental tax to reduce pollution, while an output-oriented government would set a minimum tax rate to eliminate corruption and induce technology transfers. However, a balanced government would tolerate corruption when the cost of bribing is low and the clean technology is sufficiently efficient.     

The nursing shortage: can information technology help?

There is no doubt that the nursing shortage is a real and valid concern for the medical community. American Hospital Association President Dick Davidson reports: "America needs up to 126,000 nurses now, as well as more pharmacists, lab technicians, support staff and others. We need immediate action to help alleviate this situation" (American Hospital Association, 2001). Clinical information systems can be one of those immediate actions that can help nurses feel more confident about the care they are delivering. In addition to preventing medical errors, streamlining workflow and communications, and reducing redundant data entry, these systems can have a lasting and positive effect on overall job satisfaction, providing a significant influence on retaining our invaluable nursing resources.     

Has the affordable care act affected health care efficiency?

Journal of Regulatory Economics - We utilize health care input and output data to evaluate how state-level efficiency in health care has changed in the wake of the Affordable Care Act (ACA). We use...     

Essential health care: affordable for all?

Access to affordable health care has become a national crisis. The uninsured have many faces and many reasons for being uninsured. The nation cannot afford to sustain this broken system; not in terms of resources, nor in terms of the deteriorating health of the public. Universal coverage could offer a promising opportunity to begin to ameliorate the unsustainable use of expensive illness care now substituting for effective low-cost prevention and early detection. A proposal for essential health care coverage, a balance between cost and choice to maximize use of beneficial care, is presented.     

Does new health information affect health behaviour? The effect of health events on smoking cessation

This article empirically assesses the role of new health information in the decision to quit smoking. Using individual level data from the Swiss Household Panel, health information is proxied by three different types of health events: physical health problems, mental disorders, and accidents. Exploiting retrospectively reported information on smoking behaviour, smoking cessation is modelled using a discrete time hazard model that also accounts for estimation problems arising from almost quasi-complete separation in the data. The empirical results yield robust evidence that general health problems increase the probability of instantaneous smoking cessation. Differentiating between the type of health event reveals that the overall effect is mainly driven by physical health events.     

Can government improve tax compliance by adopting advanced information technology? Evidence from the Golden Tax Project III in China

This paper explores the tax compliance effects of adopting advanced information technology by tax bureau. Although many governments adopt advanced information technology in tax collection, little is known about the effect on tax compliance. Using difference-in-differences method, we exploit a staggered reform in which tax authorities adopt a comprehensive information reporting system in China, the Golden Tax Project III. Employing listed firm level data from 2010 to 2017, using book-tax difference and its remaining component which cannot be explained by earnings management as proxy measures of tax sheltering, we find that the adoption of GTP III decreases tax sheltering levels by a 1.88 percentage point. The effect is stronger for companies with higher tax rate. By exploring channels, our results suggest that the effect works by enhancing third-party reporting and by improving tax enforcement capacity in provinces that lack tax inspectors.     

Can the affordable care act provisions explain the recent wave of acquisitions in the health insurance industry?

This research shows that the ACA health insurance exchanges have generated more merger activity in the health insurance market. The impact is robust to control for an extensive set of factors suggested by both neoclassical and behavioural frameworks. The economic impact of this ACA provision is substantial with 3.8 more months of unusually high merger activity or 52 more merger bids per year.     

Can bribery buy health? Evidence from post-communist countries

Corruption is pervasive, but we know little about its effects on individual lives. Using individual-level data from 28 post-communist countries, we demonstrate that bribing for public services worsens self-assessed health. We account for endogeneity of bribery and show that bribing for any type of public service, not just for health services, has an adverse impact. We also find that bribery lowers the quality of services received. Moreover, there are potentially high indirect costs of bribery since, as we show, it comes at the expense of cutting food consumption. These findings suggest that corruption is a potentially important source behind the poor health outcomes in many developing countries.     

A conduit for knowledge? demonstrating the strength of technology improvements in Indian firms that buy outsourced information technology

The literature on the role of information technology outsourcing (ITO) and on knowledge intensive business services only rarely considers purchasers in developing countries and includes few wide-scale studies. This paper reduces that gap in that it quantifies the effect of ITO on total factor productivity using a sample of 10,100 firms in India. The results show that ITO purchasing brings strong returns and outperforms in-house IT. A comparison with studies from elsewhere reveals that Indian ITO also outperforms IT in a range of circumstances in developed countries. Taken together, these findings support the idea that ITO firms, just like other knowledge intensive business services, can act as a conduit for best practices and tacit knowledge, and that this role is very useful in a developing country context. The implication is that more ITO projects would be good for catching up in developing countries. In India, policy support for the ITO sector should be re-designed to incentivise domestic work.     

Can health insurance coverage explain the generic competition paradox?

In the context of a three-stage model with consumers differing in their health insurance coverage, the paper shows that there exist conditions under which the price of brand-name drugs increases following the entry of generic drugs.