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Forgetting the learning curve for a moment: how much performance is unrelated to own experience?
Marco D Huesch1, Mariko Sakakibara
1Policy Academic Area, The Anderson Graduate School of Management, Los Angeles, CA 90095-1481, USA. mhuesch@anderson.ucla.edu
Abstract:
Volume-outcome relationships are of clear importance for most participants in the health-care industry; research and appropriate policy implications are of critical importance. In this letter we critique the prevailing 'learning-by-doing' view in cardiac surgery. We illustrate the very wide disparity in empirical findings on volume-outcome relationships there, in the context of broader open issues in 'learning curves' in general. Potential complementary mechanisms, e.g. 'social learning by knowledge spillovers' are introduced; these cast into doubt the prevailing policy recommendations of simple regionalization and volume smoothing.
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