Working Paper Series, Uppsala Center for Labor Studies, Department of Economics, Uppsala University
Learning-by-Doing in a Highly Skilled Profession when Stakes are High: Evidence from Advanced Cancer Surgery
(), Petter Lundborg
() and Johan Vikström
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 instru-
ment 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 sec- tor hospitals. Using detailed register data
on more than 100,000 episodes of advanced cancer surgery, our results
suggest positive eects 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.
Keywords: hospital volume; learning-by-doing; cancer surgery; survival; causal effect; (follow links to similar papers)
JEL-Codes: I11; I12; I18; L11; (follow links to similar papers)
47 pages, July 4, 2014
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