中文摘要
我们记录了在医疗保健这一利害攸关的情境中，资源稀缺程度加剧如何导致按种族配给。利用某大型医疗系统107,000例住院病例的详细带时间戳数据，我们发现，随着医院接近容量上限，黑人患者的院内死亡率上升，而白人患者的院内死亡率并未上升。这些发现无法用患者选择方面的差异来解释。我们确认，通过等待时间实施配给是其中一种机制：在几乎所有容量利用水平下，病情较重的黑人患者等待获得诊疗服务的时间都长于病情较轻的白人患者。对非结构化临床记录的文本分析表明，对医疗服务提供者投入的配给是另一种机制。
Abstract
We document how deepening resource scarcity results in rationing on the basis of race in a high-stakes setting: health care. Using detailed, time stamped data on 107,000 inpatient admissions to a large health system, we find that in-hospital mortality increases for Black but not White patients as hospitals reach capacity. These findings are not explained by differential patient selection. We identify rationing by wait times as a mechanism, documenting that sicker Black patients wait longer for care than healthier White patients at almost all capacity levels. Text analysis of unstructured clinical notes reveals rationing of provider effort as another mechanism. (JEL I11, I12, I14, J15)