Working Paper: NBER ID: w25706
Authors: Matthew C Harris; Yinan Liu; Ian McCarthy
Abstract: Unlike in the production of most goods, changes in capacity for labor-intensive services only affect outcomes of interest insofar as service providers change the way they allocate their time in response to those capacity changes. In this paper, we examine how public sector service providers respond to unexpected capacity constraints in the specific context of public health clinics. We exploit an exogenous reduction in public health clinic capacity to quantify nurses' trade-off between patients treated and time spent with each patient, which we treat as a proxy for a quality v. quantity decision. We provide evidence that these small and generally insignificant effects on nurse time favor public sector employees prioritizing quality of each interaction over clearing the patient queue.
Keywords: public health; capacity constraints; nurses; public services
JEL Codes: D24; I18; J22
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Flumist days (I19) | fewer patients seen (I11) |
| staffing reductions (J63) | changes in patient care (I11) |
| staffing reductions (J63) | prioritization of scheduled patients (I11) |
| Flumist days (I19) | decrease in total visit time (C41) |
| nurses removed for Flumist administration (I19) | significantly fewer patients seen (I11) |
| busy days (G14) | no reduction in time spent with each patient (I11) |