Selected publications highlighted below. Please see my CV for full list of papers.
Job Market Paper
If You (Re)Build It, Will They Come? Evidence from California
Available Upon Request
Hospitals in the United States spend nearly $30 billion annually on construction projects, but little is known about how these projects affect hospital admissions, hospital markets, and patient outcomes. Construction projects could improve quality of care and patient experience, but they could also increase healthcare spending and hospital market concentration. I create a novel dataset of hospital construction projects in California from 2009-2015 and link these projects to hospital admission records and quality surveys. Using difference-in-difference estimation, I find large effects of construction on patient volume, with a 14% increase in overall admissions after project opening and a 21% increase in admissions of patients with private insurance. I also examine measures of patient experience and find that patients are more likely to recommend a hospital after construction, as well as reporting their room to be quieter, though not cleaner.
COVID Papers
Characteristics of Hydroxychloroquine Dispensing in the United States, January to May 2020
Zachary Levin, Jessica Chang, Pinar Karaca-Mandic, Alí Duarte-García, and Molly Moore Jeffery
During the first months of the COVID-19 pandemic, hydroxychloroquine (HCQ) was promoted by public figures as an effective treatment despite inconclusive evidence, the potential for side effects, and subsequent shortages of this medication. We describe trends in HCQ dispensing in the early months of the pandemic.
Trends in Pediatric Hospitalizations for Coronavirus Disease 2019
Zachary Levin, Kimberly Choyke, Archelle Georgiou, Soumya Sen, and Pinar Karaca-Mandic
While early evidence and experience with coronavirus disease 2019 (COVID-19) suggests that children are less susceptible to infection and have a lower risk for symptomatic and severe disease, pediatric patients are not immune from the virus. We examined pediatric COVID-19 hospitalization trends in 22 states for indications of both severity among this population and spread of the virus.
Primary Care Papers
Practice Intentions of Family Physicians Trained in Teaching Health Centers: The Value of Community-Based Training
Zachary Levin, Peter Meyers, Lars Peterson, Andy Habib and Andrew Bazemore
Family medicine residents who graduate from Federally Qualified Health Center–aligned Teaching Health Center (THC) training residencies are nearly twice as likely to pursue employment in safety-net settings compared with non-THC graduates. This trend has been consistent over the past few years, suggesting that the program is fulfilling its mission to strengthen primary care in underserved settings.
Residency Program Characteristics and Individual Physician Practice Characteristics Associated With Family Physician Scope of Practice
Sara Martin, Robert L. Phillips Jr, Stephen Petterson, Zachary Levin, and Andrew W. Bazemore
Insufficient investment in primary care is one reason that the US health care system continues to underperform relative to the health systems in other high-income countries. States and countries with greater access to primary care clinicians and more robust primary care services have better outcomes and lower costs. For this reason, Rhode Island and Oregon have mandated measurement and targeting of primary care expenditures, and other states are considering related legislation.
Despite consistent evidence of cost savings, variations in definitions of primary care make comparisons of spending difficult, both in the US and other countries. We used national US health care survey data to assess primary care expenditures relative to other sources of health care spending.
Other Papers
Physician Practice Competition and Prices Paid by Private Insurers for Office Visits
Laurence Baker, Kate Bundorf, Anne Royalty, and Zachary Levin
Physician practice consolidation could promote higher-quality care but may also create greater economic market power that could lead to higher prices for physician services. We assess the relationship between physician competition and prices paid by private preferred provider organizations (PPOs) for 10 types of office visits in 10 prominent specialties.