with Maria Ibanez

Presented at Healthcare INFORMS Conference, INFORMS Annual Meeting, POMS Conference

Accepted for presentation at Wharton Empirical Operations Management Workshop, INFORMS Annual Meeting, Decision Science Institute Annual Meeting

In the last decade, many US states have legalized recreational cannabis. While not directly regulating healthcare providers’ activities, the potential ramifications of such laws could indirectly affect their operations by changing the patients they care for. In this paper, we study how hospital operations are influenced by recreational cannabis legalization (RCL). Using a difference-in-differences approach, we investigate the effect of recreational cannabis legalization (RCL) on hospital operations. We find that legalization alters the workload of hospital staff by changing the patient mix: While there is a null effect on total inpatient admissions, more cannabis-related patients are admitted, who, in turn, increase workload complexity. More strikingly, hospitals speed up care for other (i.e., non-cannabis) patients, with legalization shortening lengths of stay by 2.6%. We attribute this phenomenon to cannabis generating workload for hospital staff that reduces the resources (including staff time) available to other patients. We further find adverse effects on experiential quality of care and medical professionals’ compliance: First, patient satisfaction with hospital noise levels at night, hospital staff helpfulness, and information received about home recovery significantly decreases, resulting in lower experiential quality of care and potential financial damages for providers. Second, disciplinary actions against doctors, physician assistants, and nurses increase by about 34%. These findings offer evidence of another dimension—the impact on hospitals—that governments should consider when deciding on legalization and inform hospital managers about what to expect after legalization. (press here for the link to the most recent version)

with Maria Ibanez

Abstract: The US has a high maternal mortality rate, compared with other high-income countries, despite spending more per person on health care. Moreover, racial and ethnic disparities in maternal mortality persist. Black, Latina and Asian women continue to fare worse than White women regarding the likelihood of labor complications and adverse outcomes. This research paper investigates the operational implications of racial and payer disparities in medical care for mothers, focusing on the decision-making process of healthcare providers when choosing procedures in labor and delivery. Our findings indicate a concerning trend: healthcare providers opt for riskier procedures (i.e., Cesarean section) more frequently when treating non-White public insured mothers. Additionally, we observe that these patients experience shorter waiting times, suggesting a disparity in the depth of evaluation they receive. These disparities highlight critical areas for intervention to address racial inequities in maternal healthcare, emphasizing the need for improved provider decision-making processes and equal access to thorough evaluation for all mothers, regardless of their racial or insurance status.

with Maria Ibanez

with Maria Ibanez