Elizabeth Munnich

Elizabeth Munnich

Assistant Professor of Economics, University of Louisville

As an economist, why have you chosen to focus your research in healthcare?

Healthcare plays such an incredibly important role in both personal health and the economy, it is difficult to overlook that as a researcher! I’m fascinated by the ways in which healthcare markets differ from other markets we study in economics. I hope that my research can contribute to helping healthcare markets work effectively.


How did you first become interested in ambulatory surgery centers or ASCs?

I became interested in ASCs in graduate school after observing the remarkable decline in the number of hospitals in the US since the 1980s. As technological developments in medicine have made it possible for patients to recover more quickly from surgery, I wondered where patients were getting medical care outside of traditional hospital settings. I quickly came upon ASCs and was surprised at the number of economic questions that had yet to be answered about the outpatient surgery market.


Based on your research, what conclusions have you drawn about the value provided by ASCs relative to other sites of service?

I don’t have access to direct cost measures for ASCs, but I have shown that ASCs perform cases faster than hospital outpatient departments, and they appear to do so without sacrificing quality of care.


What has your research revealed about the quality of care provided by ASCs relative to other sites of care?

This area of research poses a lot of empirical challenges as ASCs on average have a healthier patient mix than hospitals and finding good measures of quality in existing datasets is not straightforward. I’ve had to be very careful about trying to address these problems in my research, and I have documented that for high-volume procedures, patients who were cared for in ASCs were less likely to visit an ER or be admitted to a hospital shortly after surgery than those who were cared for in a hospital outpatient department.


Looking ahead, what additional research related to ASCs and interests in the field of outpatient surgery would you like to pursue or see others conduct?

There is a lot of work to be done to understand the cost and quality differences between ASCs and hospital outpatient departments. Additionally, one of the possible benefits of ASCs is that they introduce more choices for consumers, and greater competition in the outpatient surgery market could result in lower prices and higher quality of care. I think that better understanding the role of ASCs in this competitive landscape will help to inform healthcare providers, insurance companies and policy makers.


Posted 6.12.19