高质量的医生就有高质量的病人吗?

Emilia Simeonova, Niels Skipper, Peter R. Thingholm
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摘要

是什么让一些医生比其他医生表现得更好?本文考察了两种不同的渠道,通过这两种渠道,初级保健医生的病人管理方式可以影响健康结果:通过开出适当的临床治疗处方,以及通过激发更好的病人健康管理,这反映在病人对该治疗的坚持上。利用丹麦他汀类药物使用者的数据,将患者与初级保健医生相匹配,我们表明医生的临床质量对患者健康结果的影响在很大程度上可以通过医生实践中患者的构成来解释。相比之下,即使在控制了患者组成之后,医生在促进遵守处方药方面的技能对患者的结果也保持着巨大的积极影响。我们还表明,坚持服用常用的抗胆固醇药物对健康的影响是巨大而显著的。
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Do High Quality Physicians Have High Quality Patients?
What makes some physicians perform better than others? This paper examines two different channels through which primary care doctors’ patient management styles can affect health outcomes: by prescribing the appropriate clinical therapy and by inspiring better patient health management, as reflected in the patient’s adherence to that therapy. Using data on the population of statin-users in Denmark that matches patients to primary care physicians, we show that the impact of a physician’s clinical quality on patient health outcomes is largely explained by the composition of patients in the physician’s practice. In contrast, the physician’s skill in facilitating adherence to prescription drugs maintains large and positive effects on patient outcomes even after controlling for patient composition. We also show that the health effects of adherence to commonly prescribed anti-cholesterol drugs are large and significant.
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