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Using a novel dataset of California hospital construction projects opening between 2010 and 2019, we estimate the effect of project opening on patient experience and clinical measures using a difference-in-differences framework. We find sizable, statistically significant improvements in patient experience\u2014cleanliness, quietness at night, and likelihood to recommend\u2014with effects persisting for at least 2 years after opening. We find no measurable impact on clinical outcomes, 30-day mortality, and readmission for heart attacks and heart failure. These results suggest infrastructure investments meaningfully affect perceived care environments but may not translate into near-term changes in clinical performance. Policymakers and hospital leaders should weigh these returns when evaluating capital expenditures and potential support for hospital construction.<\/jats:p>","DOI":"10.1177\/10775587261471942","type":"journal-article","created":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T08:16:00Z","timestamp":1786868160000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Hospital Infrastructure Investment on Quality of Care"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0913-1034","authenticated-orcid":false,"given":"Zachary","family":"Levin","sequence":"first","affiliation":[{"name":"Federal Trade Commission, Chicago, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,16]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"crossref","unstructured":"Adelino M. Lewellen K. McCartney W. B. (2022). 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