Evidence map›Paper›PMID 30672042›Full record

ArticleHealth economics2019

Use of instrumental variables for endogenous treatment at the provider level.

R Tamara Konetzka, Fan Yang, Rachel M Werner

Open access · greenAbstract readLetter
In one paragraph

Article in Health economics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
  2. Impact of skilled nursing facility quality on Medicare beneficiaries with dementia: Evidence from vacancies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
    Article
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 1 country.

R Tamara KonetzkaDepartment of Public Health Sciences, The University of Chicago, Chicago, Illinois.ORCID 0000-0003-3016-1318
Fan YangDepartment of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado.
Rachel M WernerDivision of General Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Chicago Department of Public Health · USColorado School of Public Health · USUniversity of Pennsylvania · US

Funding

Midcareer Mentoring Award for Patient-Oriented Research in AgingK24AG047908 · NIA · UNIVERSITY OF PENNSYLVANIA · PI WERNER, RACHEL M · 2014 to 2024
$2.0M
NIA NIH HHS K24 AG047908
6 · The paper itself

Abstract

Health economists are often interested in the effects of provider-level attributes (e.g., nonprofit status or quality rating) on patient outcomes, but estimation is subject to selection bias due to correlation with other omitted provider-level attributes that also affect patient outcomes. Recently, researchers have attempted to use patient-level instrumental variables, such as differential distance, to solve this problem of a provider-level endogenous treatment variable in settings where patients are nested within providers. However, to satisfy validity assumptions, an instrumental variable for a provider attribute must be at the provider level or a larger unit of aggregation, not at the patient level. A patient-level instrument cannot predict variation in a provider attribute separately from other, potentially unmeasured, provider attributes. In this paper, we explain this misapplication, review the extent of this problem in recent literature, and offer alternative approaches to avoid this misapplication of patient-level instrumental variables.

Indexed as

BiasModels, StatisticalResearch DesignData Interpretation, StatisticalHealth PersonnelHumansendogeneityinstrumental variables

Identifiers

PMID30672042
PMCPMC6462231
OpenAlexW2912853264

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.