Forgetting the learning curve for a moment: how much performance is unrelated to own experience?
✍ Scribed by Marco D. Huesch; Mariko Sakakibara
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 103 KB
- Volume
- 18
- Category
- Article
- ISSN
- 1057-9230
- DOI
- 10.1002/hec.1412
No coin nor oath required. For personal study only.
✦ Synopsis
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. Copyright © 2008 John Wiley & Sons, Ltd.