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| Main Authors: | , , |
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| Format: | Preprint |
| Published: |
2026
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| Subjects: | |
| Online Access: | https://arxiv.org/abs/2603.23024 |
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| _version_ | 1866911541452865536 |
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| author | Rashidi, Moslem Connelly, Luke B. Fiorentini, Gianluca |
| author_facet | Rashidi, Moslem Connelly, Luke B. Fiorentini, Gianluca |
| contents | We study how a first heart-failure hospitalization, an adverse health shock, changes patients' care, and whether a nurse-led chronic-care program sustains those post-shock investments. Using linked population-wide administrative records from Italy's Romagna Local Health Authority (2017-2023), we anchor event time at each patient's first CHF admission and exploit staggered timing to estimate dynamic effects. The shock triggers a sharp post-discharge surge: beta-blocker adherence, cardiology follow-up, and echocardiography rise immediately, while emergency-room use spikes just before admission and then stabilizes. We then estimate the incremental impact of enrollment in the Nurse-led Program for Chronic Patients (NPCP) using the interaction-weighted event-study estimator for staggered adoption. Under conventional difference-in-differences inference, NPCP strengthens long-run preventive engagement, with little detectable change in emergency-room use. HonestDiD sensitivity analysis indicates these gains are economically meaningful but not statistically definitive under modest departures from parallel trends. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2603_23024 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | Heart Failure's First Shock and Nurse-Led Chronic Care Rashidi, Moslem Connelly, Luke B. Fiorentini, Gianluca General Economics Economics We study how a first heart-failure hospitalization, an adverse health shock, changes patients' care, and whether a nurse-led chronic-care program sustains those post-shock investments. Using linked population-wide administrative records from Italy's Romagna Local Health Authority (2017-2023), we anchor event time at each patient's first CHF admission and exploit staggered timing to estimate dynamic effects. The shock triggers a sharp post-discharge surge: beta-blocker adherence, cardiology follow-up, and echocardiography rise immediately, while emergency-room use spikes just before admission and then stabilizes. We then estimate the incremental impact of enrollment in the Nurse-led Program for Chronic Patients (NPCP) using the interaction-weighted event-study estimator for staggered adoption. Under conventional difference-in-differences inference, NPCP strengthens long-run preventive engagement, with little detectable change in emergency-room use. HonestDiD sensitivity analysis indicates these gains are economically meaningful but not statistically definitive under modest departures from parallel trends. |
| title | Heart Failure's First Shock and Nurse-Led Chronic Care |
| topic | General Economics Economics |
| url | https://arxiv.org/abs/2603.23024 |