Northwestern University  
ZENON ZABINSKI
DEPARTMENT OF ECONOMICS


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408-439-3110 (mobile)
847-491-7001 (fax)

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Zenon Zabinski

Ph.D. Candidate
Department of Economics

Ph.D., Economics, Northwestern University, 2014 (expected)
M.A., Economics, Northwestern University, 2009
B.S., Computer Engineering, Santa Clara University, 2007

Fields of Specialization

Economics of Healthcare, Industrial Organization

Curriculum Vitae: [pdf]

Job Market Paper:

Product Quality Choice Under Weak Price Competition: Hospital Adoption of Robotic Surgery [pdf]
           [This version: Nov 12, 2013.]

Abstract: Economic theory predicts overprovision of product quality is more likely in markets characterized by weak price competition. A prominent explanation of high healthcare costs in the U.S. is that inflexible pricing combined with free entry leads to overinvestment in high cost technologies. In this paper, I ask whether hospital competition results in excessive adoption of robotic surgery, generating outlays on fixed costs without commensurate benefit to total welfare. To measure the welfare consequences, I use observed geographic variation in patient treatment decisions to estimate a novel model of consumer demand for surgery, in which patients choose among multiple treatment alternatives. Results show that all profits due to hospital adoption after 2008 come from business stealing, so all spending on robotic surgery reduces industry profits dollar for dollar. Moreover, the contribution to patient surplus accounts for only 4.8% of fixed costs, implying that continued diffusion of robotic surgery is inefficient from a social welfare perspective.

Other Papers:

The Deterrent Effect of Tort Law: Evidence from Medical Malpractice Reform
          [with Bernard S. Black, in progress]

Abstract: A principal goal of tort law is to deter negligent behavior, but there is limited empirical evidence on whether it does so. We study that question for medical malpractice liability. We examine whether medical malpractice ("med mal") reforms, affect in-hospital patient safety, using Patient Safety Indicators (PSIs) -- measures of adverse events developed by the Agency for Healthcare Research and Quality -- as proxies for overall safety. In Texas, which experienced a large reform shock in 2003, we find a post-reform decline in patient safety compared to control states, for a pooled measure and a number of individual PSIs, and improvement in none of the PSIs. The quality decline appears gradually over the post-reform period. We find consistent results for several other states which adopt significant med mal reforms.

The Association between Patient Safety Indicators and Medical Malpractice Risk: Evidence from Texas
          [with Bernard S. Black, in progress]

Abstract: We study whether rates of adverse hospital events, as proxies for hospital safety, predict rates of paid medical malpractice ("med mal") claims. Our safety measures are 17 adult Patient Safety Indicators (PSIs) -- measures developed by the Agency for Healthcare Research and Quality of adverse events, many of which are avoidable. We find strong correlations among most PSIs: counties with high rates on one PSI usually have high rates on other PSIs. We also find a strong association between PSI rates and med mal claim rates. A pooled measure of PSI rates predicts higher med mal claim rates in pooled OLS and county random effects regressions. Results with county fixed effects are weaker and sensitive to specification. Our results, if causal, suggest that, contrary to the views of many health care providers, med mal claims that lead to payouts are not a random event. Instead, hospitals that improve patient safety can reduce med mal payouts. We also study local variation in patient safety, in the spirit of the Dartmouth Atlas work on variation in treatment intensity. We find large variations, both across counties and across hospitals within counties. This suggests that many adverse hospital events are avoidable at reasonable cost, since some hospitals are avoiding them.

The Effect of Competition on Hospital Technology Adoption: An Instrumental Variable Analysis
          [in progress]

References:

Prof. David Dranove (Committee Chair)
Prof. Bernard Black
Prof. Michael Mazzeo


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