The Nature of Surgeon Human Capital Depreciation

NBER Working Paper No. 20017

Issued in March 2014

NBER Program(s):Health Care, Health Economics



To test how practice interruptions affect worker productivity, we estimate how temporal breaks affect surgeons' performance of coronary artery bypass grafting (CABG). Using a sample of 188 surgeons who performed 56,315 CABG procedures in Pennsylvania between 2006 and 2010, we find that a surgeon's additional day away from the operating room raised patients' inpatient mortality risk by up to 0.067 percentage points (2.4% relative effect) but reduced total hospitalization costs by up to 0.59 percentage points. In analyses of 93 high-volume surgeons treating 9,853 patients admitted via an emergency department, where temporal distance effects are most plausibly exogenous, an additional day away raised mortality risk by 0.398 percentage points (11.4% relative effect) but reduced cost by up to 1.396 percentage points. These estimates imply a cost per life-year saved ranging from $7,871 to $18,500, rendering additional treatment intensity within surgery cost-effective at conventional cutoffs. Our findings are consistent with the hypothesis that after returning from temporal breaks surgeons may be less likely to recognize and address life-threatening complications, in turn reducing resource use. This form of human capital loss would explain the decrease in worker productivity and the simultaneous reduction in input use.

Acknowledgments and Disclosures

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Document Object Identifier (DOI): 10.3386/w20017

Published: Hockenberry, Jason M. & Helmchen, Lorens A., 2014. "The nature of surgeon human capital depreciation," Journal of Health Economics, Elsevier, vol. 37(C), pages 70-80. citation courtesy of

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