Scandinavian Working Papers in Economics
Working Paper Series,
IFAU - Institute for Evaluation of Labour Market and Education Policy
No 2014:7: Learning-by-doing in a highly skilled profession when stakes are high: evidence from advanced cancer surgery
Daniel Avdic (), Petter Lundborg () and Johan Vikström ()
Additional contact information
Daniel Avdic: Department of Ecconomics, Uppsala University, Postal: P O Box 513, SE-751 20 Uppsala, Sweden
Petter Lundborg: Department of Economics, Lund University, Postal: Lund, Sweden
Johan Vikström: IFAU - Institute for Evaluation of Labour Market and Education Policy, Postal: P O Box 513, SE-751 20 Uppsala, Sweden
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.
Keywords: hospital volume; learning-by-doing; cancer surgery; survival; causal effect
47 pages, March 26, 2014
Full text files
wp2014-07-Learning-b...-stakes-are-high.pdf
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