Learning, forgetting, and hospital quality: an empirical analysis of cardiac procedures in Maryland and Arizona
建立了一个包含遗忘的学习模型，分析马里兰州和亚利桑那州两家医院的心脏手术数据，发现学习效应并不显著，因此不支持通过集中手术量来提高质量的监管政策。
This paper sets out an empirical model of learning with forgetting and uses it to estimate how much hospital quality improves with experience. The size of the learning effect and the depreciation rate are estimated for two cardiac procedures in Maryland and Arizona. Models are estimated using patient survival as the outcome of interest. The results show that learning does not appear to be a factor in hospital quality for either procedure or for surgery generally. From a policy standpoint, based on these results, regulations in Maryland that seek to concentrate these two procedures among a small number of providers could not be justified on the grounds that higher volume would increase the quality of care.