Wichmann Bruno, Moreira Wichmann Roberta
Department of Resource Economics and Environmental Sociology, College of Natural and Applied Sciences, University of Alberta, 503 General Services Building, Edmonton, T6G-2H1, AB, Canada.
World Bank, SCES Trecho 03, Lote 05, Ed. Polo 8, S/N, Brasília, DF, CEP 70200-003, Brazil.
Eur J Health Econ. 2024 Jun;25(4):717-730. doi: 10.1007/s10198-023-01621-7. Epub 2023 Aug 6.
We develop a nonparametric model to study health spillover effects of policy interventions. We use double/debiased machine learning to estimate the model using data from 74 hospitals in Rio de Janeiro, Brazil, and examine cross-patient spillover effects during the COVID-19 pandemic. The pandemic forced hospitals to develop new protocols to offer intensive care to both COVID and non-COVID patients. Our results show that the need to care for COVID patients affects health outcomes of non-COVID patients. Controlling for a number of confounders, we find that mortality rates and length of stay of non-COVID ICU patients increase when hospitals simultaneously offer intensive care to both types of patients. Policy simulations suggest that an increase in the number of ICU beds can counter morbidity spillover, but it is unlikely to be a feasible approach to counter mortality spillover.
我们开发了一个非参数模型来研究政策干预的健康溢出效应。我们使用双重/去偏机器学习，利用巴西里约热内卢74家医院的数据来估计该模型，并研究新冠疫情期间患者之间的溢出效应。疫情迫使医院制定新方案，为新冠患者和非新冠患者提供重症监护。我们的结果表明，照顾新冠患者的需求会影响非新冠患者的健康结局。在控制了多个混杂因素后，我们发现，当医院同时为两类患者提供重症监护时，非新冠重症监护病房患者的死亡率和住院时间会增加。政策模拟表明，增加重症监护病床数量可以抵消发病率溢出，但不太可能是抵消死亡率溢出的可行方法。
