初级保健医生执业风格和病人护理:来自医疗保险医生退出的证据

Itzik Fadlon, Jessica Van Parys
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引用次数: 27

摘要

在美国,初级保健医生(pcp)为患者提供一线医疗保健;然而,目前尚不清楚他们的执业风格如何影响患者护理。在本文中,我们通过关注受PCP搬迁或退休(我们称之为“退出”)影响的医疗保险患者,来估计PCP实践风格对患者医疗保健利用的长期影响。观察患者在这些退出后接受护理的情况,我们估计事件研究来比较切换到不同实践风格强度的pcp的患者。我们发现pcp对一系列综合利用措施有很大的影响,包括医生和门诊支出以及诊断疾病的数量。此外,我们发现pcp对患者接受的护理质量有很大的影响,并且所有这些影响都会持续数年。我们的研究结果表明,转向高质量的pcp可以显著影响患者的长期健康结果。
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Primary Care Physician Practice Styles and Patient Care: Evidence from Physician Exits in Medicare
Primary care physicians (PCPs) provide frontline health care to patients in the U.S.; however, it is unclear how their practice styles affect patient care. In this paper, we estimate the long-lasting effects of PCP practice styles on patient health care utilization by focusing on Medicare patients affected by PCP relocations or retirements, which we refer to as "exits." Observing where patients receive care after these exits, we estimate event studies to compare patients who switch to PCPs with different practice style intensities. We find that PCPs have large effects on a range of aggregate utilization measures, including physician and outpatient spending and the number of diagnosed conditions. Moreover, we find that PCPs have large effects on the quality of care that patients receive, and that all of these effects persist for several years. Our results suggest that switching to higher-quality PCPs could significantly affect patients' longer-run health outcomes.
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