Rationing by Race

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)