Economics of health IT

Madeline F Perry, Kristan Scott +5

Do venture-backed maternal health startups target the populations and problems driving the US maternal health crisis? This cross-sectional study used financial databases and dual-coder content analysis of company websites to characterize US perinatal startups founded between 2014 and 2022, identifying 439 companies, of which 183 met inclusion criteria and 172 were venture-funded in their last round. These firms raised $977.5 million, with 52% ($508.3 million) concentrated in three companies. Among 133 actively operating firms, virtual or hybrid wraparound pregnancy care was most common (34.6%), while 17.3% mentioned health equity and 18.1% maternal mortality; fewer than half of eligible startups accepted insurance and fewer accepted Medicaid.

Kaylyn Sanbower, Ian McCarthy, Leonardo Sanchez-Aragon

Do online star ratings shift where patients go for elective inpatient care? The authors link the universe of hospital Yelp reviews to Florida inpatient claims for elective procedures (2012-2017), exploiting exogenous variation in ratings to identify causal effects on hospital selection. A one-standard-deviation increase in a hospital's within-market rating percentile rank — roughly half a star — was associated with patients traveling 7.9% farther for labor and delivery and 33.5% farther for orthopedic surgery. Falsification tests using emergency admissions were null, consistent with ratings influencing elective rather than urgent choices.

Matteo Devigili, Erdem Dogukan Yilmaz +2

Does generative AI change which human skills firms hire for? Using ChatGPT's release as an exogenous shock in a quasi-experimental design, the authors track job-posting demand across 1,820 publicly listed U.S. companies over a ±12-month window, classifying postings into five organizing skills: task division, task allocation, information provision, reward distribution, and exception management, with a queuing-theory model predicting which fall first. Demand declined significantly for monitoring (reward distribution), operational exceptions, and task division, with information provision also falling; task allocation and conflict resolution were more stable. Declines intensified after GPT-4's release. The abstract reports no effect sizes.

Ekaterina Jussupow, Kevin Bauer +3

Does mandating disclosure of generative AI use change how creators themselves work with AI, before any audience sees the label? The authors theorize an "indirect disclosure effect" grounded in Goffman's impression management and test it in two nested mixed-methods experiments in which participants collaborated with a text-to-image GenAI tool under varying disclosure conditions. When disclosure was anticipated, the majority of creators withdrew from the creative process and ceded image generation to the tool, a shift attributed to fears that audiences would not recognize their creative agency; resulting artifacts reflected computational rather than human creativity and were evaluated as such regardless of the label. The abstract reports no effect sizes or sample sizes.

Sameer Borwankar, Warut Khern-am-nuai +2

What happens to user-generated content when a Q&A platform bans generative AI? Using a difference-in-differences design comparing Stack Overflow with Reddit's AskProgramming subreddit around Stack Overflow's prohibition on ChatGPT-generated posts, the authors applied NLP measures of linguistic characteristics plus voting and posting-frequency data. After the restriction, Stack Overflow answers showed greater language complexity, positivity, and length, and received more upvotes, while questions were unaffected; the volume of questions and answers and the number of first-time contributors declined. Findings were corroborated by Italy's temporary nationwide ChatGPT ban and a scenario-based experiment with 440 participants indicating compensatory knowledge signaling. The abstract reports no effect sizes.

Does mandatory electronic reporting with automated auditing improve regulatory compliance and environmental performance? Using a difference-in-differences design, the authors evaluate the first U.S. program requiring online reporting and automated auditing of wastewater discharge releases, framing it as a test case for AI-based compliance tools with automated feedback. The program was associated with more complete reporting, reduced discharges, and a higher rate of reported violations, with larger effects among minor dischargers and publicly owned facilities. The authors also find evidence that state authorities targeted inspections toward plants with recent noncompliance, a possible mechanism. The abstract reports no effect sizes or point estimates.

Lin, A. L., Curtis, S. +11

How much labor and cost does manual fax routing consume in a specialty division? This two-phase quality improvement study at Duke's Division of Cardiology paired an observational time study at three ambulatory clinics (April 1–July 12, 2024) with a volume count of all inbound faxes to the divisional communication hub (July 1–December 31, 2025). Processing took 4.4 to 9.4 minutes per fax (mean 6.0). The hub received 24,420 faxes, averaging 4,070 faxes and 13,341 pages monthly, implying 407 person-hours and $10,663.40 per month, about 2.5 FTEs. No AI automation was evaluated; the authors frame fax routing as an automation target.