Shocks to Hospital Occupancy and Mortality: Evidence from the 2009 H1N1 Pandemic

What is the effect of increased hospital occupancy on in-hospital mortality? Using data from public hospitals in Mexico, we exploit the shock in hospitalizations induced by the 2009 H1N1 pandemic, instrumenting hospital admissions due to acute respiratory infections (ARIs) with measures of ARIs at nearby healthcare facilities. We estimate that a one standard deviation increase in ARI admissions leads to a 38% increase in non-ARI in-hospital mortality. We show that these effects are non-linear in the size of the local outbreak, and are concentrated in hospitals with limited infrastructure. We discuss policy implications for the current pandemic