Information in the production of health; evidence on how physicians collect, respond to, and exchange information.

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This dissertation consists of three papers on the topic of information and physician behaviour. In the first chapter, I examine how physicians respond to changes in the information that a triage system provides. Using these quasi-random changes in a regression discontinuity framework I show that similar patients are assigned different levels of measured acuity. These cause large changes in resource allocations across these patients with sicker looking patients receiving more treatment time, more imaging tests, and more admissions to hospital. They do not result in any change in the bouncebacks to hospital or deaths suggesting that increased resource use among similar patients does not result in improved health outcomes. In the second chapter, I examine how physicians use inputs into information collection. These consist of time spent with patients and imaging tests and I leverage emergency department wait-line crowding and the closure of imaging departments to assess effects of one input on the other. I estimate effects using an instrumental variable and regression discontinuity identification strategy respectively. Additional crowding causes reductions in the time physicians spend with patients causing reductions in imaging test use. Conversely, closure of the imaging department reduces time spent with patients. However, both interact together to produce better health for patients. In the third chapter, I examine how a complaint against a radiologist affected information transfer to emergency physicians and their decisions. I leverage this as a difference in difference estimation strategy by comparing persons who receive imaging tests to those who do not. The complaint and subsequent review of the complaint is associated with changes in the information given to emergency physicians. This results in small and transient changes in the probability of the emergency physician consulting specialists or admitting a patient to the hospital.

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133 pages


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Cawley, John

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Nicholson, Sean
Miller, Douglas

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Public Policy

Degree Name

Ph. D., Public Policy

Degree Level

Doctor of Philosophy

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Attribution 4.0 International


dissertation or thesis

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