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Thomas Hoe

I am an applied microeconomist with research interests in healthcare and public economics.

In my job market paper I examine the incentives of hospitals to ration care. I show that as hospitals become more crowded, the patients they treat experience worse health outcomes. I then evaluate whether consumers would benefit from policies that reduce crowding but increase waiting times for non-emergency appointments. I find that these policies would reduce consumer welfare, and consumers would instead benefit from more crowding and worse health outcomes because of the waiting time benefits that this creates. 

In my other research papers I examine: (i) how physicians respond when pressured to reduce waiting times in the emergency department; and (ii) the incentives created by readmission penalties and the role of discharge decisions in causing readmissions.

My past experience includes working as an economist in the public and private sector on policy issues in antitrust, healthcare, and financial services.

  • Healthcare
  • Public economics.

"Are Public Hospitals Overcrowded? Evidence from Trauma and Orthopaedics in England"

Abstract

Hospitals face a trade-off between how many non-emergency patients to admit each period ('crowding') and how long these patients must wait for an appointment ('waiting'). This paper evaluates this trade-off at public hospitals in England. I first exploit pseudo-random variation in emergency admissions to estimate the short-run effects of crowding on patient health outcomes. I find that crowding has adverse effects, causing the rate of unplanned readmission to vary by up to 22%. I show that variation in length of stay caused by binding bed constraints is a plausible mechanism for these effects. I then evaluate policies which reduce crowding by rationing non-emergency admissions and thereby increasing waiting times. I estimate the impact of non-emergency admissions on equilibrium waiting times by exploiting technological change and compare this to the crowding effects in a model of consumer welfare. The optimal rationing condition implied by the model is strongly rejected by the data and the results indicate that policies in England undervalue preferences for waiting times. Policies which increase elective admissions, reducing waiting times but increasing readmissions, are therefore predicted to improve consumer welfare. 

  • Richard Blundell (UCL)
  • Aureo de Paula (UCL)
  • Orazio Attanasio (UCL)
  • Jonathan Gruber (MIT)