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An Overview of Geographically Discontinuous Treatment Assignments with an Application to Children’s Health Insurance

aGeorgetown University, Washington, DC, USA
bThe Children’s Hospital of Philadelphia and School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
cDepartment of Statistics, University of Pennsylvania, Philadelphia, PA, USA
dDepartment of Political Science, University of Michigan, Ann Arbor, MI, USA

Regression Discontinuity Designs

ISBN: 978-1-78714-390-6, eISBN: 978-1-78714-389-0

Publication date: 13 May 2017


We study research designs where a binary treatment changes discontinuously at the border between administrative units such as states, counties, or municipalities, creating a treated and a control area. This type of geographically discontinuous treatment assignment can be analyzed in a standard regression discontinuity (RD) framework if the exact geographic location of each unit in the dataset is known. Such data, however, is often unavailable due to privacy considerations or measurement limitations. In the absence of geo-referenced individual-level data, two scenarios can arise depending on what kind of geographic information is available. If researchers have information about each observation’s location within aggregate but small geographic units, a modified RD framework can be applied, where the running variable is treated as discrete instead of continuous. If researchers lack this type of information and instead only have access to the location of units within coarse aggregate geographic units that are too large to be considered in an RD framework, the available coarse geographic information can be used to create a band or buffer around the border, only including in the analysis observations that fall within this band. We characterize each scenario, and also discuss several methodological challenges that are common to all research designs based on geographically discontinuous treatment assignments. We illustrate these issues with an original geographic application that studies the effect of introducing copayments for the use of the Children’s Health Insurance Program in the United States, focusing on the border between Illinois and Wisconsin.




For helpful comments and suggestions we thank Matias Cattaneo, Sebastian Galiani, Patrick McEwan, two anonymous reviewers, and participants at the Advances in Econometrics conference held in May 2016 at the Department of Economics at the University of Michigan. Titiunik gratefully acknowledges financial support from the National Science Foundation (SES 1357561).


Keele, L., Lorch, S., Passarella, M., Small, D. and Titiunik, R. (2017), "An Overview of Geographically Discontinuous Treatment Assignments with an Application to Children’s Health Insurance ", Regression Discontinuity Designs (Advances in Econometrics, Vol. 38), Emerald Publishing Limited, Leeds, pp. 147-194.



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