Please use this identifier to cite or link to this item: http://hdl.handle.net/10419/106266
Authors: 
Avdic, Daniel
Lundborg, Petter
Vikström, Johan
Year of Publication: 
2014
Series/Report no.: 
Working Paper, IFAU - Institute for Evaluation of Labour Market and Education Policy 2014:7
Abstract: 
Although learning-by-doing is believed to be an important source of productivity growth, there is limited evidence that production volume affects productivity in a causal sense. We document evidence of learning-by-doing in a highly skilled profession where stakes are high; advanced cancer surgery. For this purpose, we introduce a novel instrument that exploits the closure and opening of entire cancer clinics which have given rise to sharp and exogenous changes in the cancer surgical volumes at Swedish public sector hospitals. Using detailed register data on more than 100,000 episodes of advanced cancer surgery, our results suggest positive effects of surgery volumes on survival. In addition, we provide evidence on the mechanisms through which these improvements occur. We also show that the results are not driven by changes in patient composition or by other changes at the hospital level.
Subjects: 
hospital volume
learning-by-doing
cancer surgery
survival
causal effect
JEL: 
I11
I12
I18
L11
Document Type: 
Working Paper

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