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Category Archives: O33

The Effects of Health IT Innovation on Throughput Efficiency in the Emergency Department

By Michael Levin  

Overcrowding in United States hospitals’ emergency departments (EDs) has been identified as a significant barrier to receiving high-quality emergency care, resulting from many EDs struggling to properly triage, diagnose, and treat emergency patients in a timely and effective manner. Priority is now being placed on research that explores the effectiveness of possible solutions, such as heightened adoption of IT to advance operational workflow and care services related to diagnostics and information accessibility, with the goal of improving what is called throughput efficiency. However, high costs of technological process innovation as well as usability challenges still impede wide-spanning and rapid implementation of these disruptive solutions. This paper will contribute to the pursuit of better understanding the value of adopting health IT (HIT) to improve ED throughput efficiency.

Using hospital visit data, I investigate two ways in which ED throughput activity changes due to increased HIT sophistication. First, I use a probit model to estimate any statistically and economically significant decreases in the probability of ED mortality resulting from greater HIT sophistication. Second, my analysis turns to workflow efficiency, using a negative binomial regression model to estimate the impact of HIT sophistication on reducing ED waiting room times. The results show a negative and statistically significant (p < 0.01) association between the presence of HIT and the probability of mortality in the ED. However, the marginal impact of an increase in sophistication from basic HIT functionality to advanced HIT functionality was not meaningful. Finally, I do not find a statistically significant impact of HIT sophistication on expected waiting room time. Together, these findings suggest that although technological progress is trending in the right direction to ultimately have a wide-sweeping impact on ED throughput, more progress must be made in order for HIT to directly move the needle on confronting healthcare’s greatest challenges.

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Advisors: Professor Ryan McDevitt, Professor Michelle Connolly | JEL Codes: I1, I18, O33

Patrolling the Future: Unintended Consequences of Predictive Policing in Chicago

By Jenny Jiao   

In the past decade, police departments have increasingly adopted predictive policing programs in an effort to identify where crimes will occur and who will commit them. Yet, there have been few empirical analyses to date examining the efficacy of such initiatives in preventing crime. Using police and court data from the second-largest police department in the country, this paper seeks to evaluate the pilot version of Chicago’s Strategic Subject List, a person-based predictive policing program. Using a boundary discontinuity design, I find that individuals eligible for the Strategic Subject List were 2.07 times more likely to be found not guilty of all charges in court than similarly situated individuals in the control group. Taking into account crime category heterogeneity, I find evidence that individuals previously arrested for drug crimes drive this result. This research sheds light on the potential unintended consequences of person-based predictive policing.

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Advisors: Professor Patrick Bayer, Professor Bocar Ba | JEL Codes: K4, K42, O33

What Fosters Innovation? A CrossSectional Panel Approach to Assessing the Impact of Cross Border Investment and Globalization on Patenting Across Global Economies

By Michael Dessau and Nicholas Vega

This study considers the impact of foreign direct investment (FDI) on innovation in high income, uppermiddle  income and lowermiddle income countries. Innovation matters because it is a critical factor for economic growth. In a panel setting, this study assesses the degree to which FDI functions as a vehicle for innovation as proxied by scaled local resident patent applications. This study considers research and development (R&D), domestic savings, imports and exports, and quality of governance as factors which could also impact the effectiveness of FDI on innovation. Our results suggest FDI is most effective as inward direct investment in countries outside the technological frontier possessing adequate existing domestic investment capital and R&D spending to convert foreign investment capital and technological spillover into innovation. Nonetheless, FDI was not a consistent indicator for innovation; rather, the most consistent indicators across this study were R&D and domestic savings. Differences amongst income groups are highlighted as well as their varying responses to our array of causal factors.

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Advisor: Lori Leachman | JEL Codes: A10, B22, C82, E00, E02, O10, O11, O30, O31, O32, O33, O34, O43

The Rise of Mobile Money in Kenya: The Changing Landscape of M-PESA’s Impact on Financial Inclusion

By Hong Zhu

M-PESA, the hugely popular mobile money system in Kenya, has been celebrated for its potential to “bank the unbanked” and increase access to financial services. This paper provides evidence to support this idea and explores mechanisms through which this might be the case. It specifically looks at the savings products held by individuals and how this changes in relation to M-PESA use. It then constructs an index for measuring the extent to which individuals are integrated into the formal financial sector. This paper argues that M-PESA’s effect on financial inclusion is a growing phenomenon, which suggests that keeping pace with the rapid evolutions of this mobile money system should be a high priority for researchers. As this paper elucidates, M-PESA has become notably more integrated with the formal financial sector in 2013 as compared to 2009, which holds implications for user behavior.

Honors Thesis

Advisor: Michelle Connolly, Xiao Yu Wang | JEL Codes: D14, E42, G21, G23, O1, O17, O16, O33 | Tagged: Financial Inclusion, Mobile Money, Savings,Technology

Questions?

Undergraduate Program Assistant
Jennifer Becker
dus_asst@econ.duke.edu

Director of the Honors Program
Michelle P. Connolly
michelle.connolly@duke.edu