Brad Curtis
I am a fifth-year Ph.D. candidate in Economics at the University of Georgia CV
I will be on the 2025-2026 job market
My research fields are Health Economics and Industrial Organization
Contact Information: Bradley.Curtis@uga.edu
Job Market Paper: The Cost of Clarity: Tradeoffs to Public Investments in Rural Diagnostic Care Link
Abstract
Rural hospitals face financial constraints that hinder investment in new medical technologies. Disinvestment contributes to regional disparities in health care quality, particularly in capital-intensive service lines like imaging, where reliance on outdated equipment increases the risk of diagnostic errors. To address access gaps, recent policy efforts have funded investment subsidies for rural hospitals. By expanding access to advanced medical technologies, these policies can meaningfully improve clinical outcomes for underserved rural populations. However, housing high-cost technologies at low-volume rural hospitals may not be cost-effective. This paper examines the cost-access trade-off associated with deploying expensive diagnostic equipment in rural markets by studying the diffusion of 3D-mammography (3DM). My analysis focuses on the market for breast cancer screenings in rural Georgia, where a subsidy for rural hospitals alleviated financial constraints, facilitating the adoption of 3DM. Leveraging changes in geographic access to 3DM over time, I demonstrate how distance to 3DM affects patients' technology choices and screening outcomes. Following the adoption of 3DM at a rural hospital, I estimate a 45 percentage point increase in the probability that local patients will screen with 3DM instead of 2D mammography (2DM). Increased 3DM uptake improves local screening outcomes, reducing the average likelihood of a false-positive screening by 1.8 percentage points (21 percent). To study the effect of subsidized technology adoption, I estimate a structural model of demand for mammography. Counterfactual analyses show that a blanket investment policy funding 3DM upgrades at every rural hospital is inefficient, resulting in over-investment in high-access markets where adoption is socially redundant, or in sparsely populated markets that cannot sustain sufficient demand. Welfare is maximized by a targeted investment policy that allocates 3DM scanners to hospitals operating in midsize markets where patients are geographically isolated from incumbent 3DM providers.