Physician workload and treatment choice: the case of primary care

• 成果类型: Article
• 署名作者: Shurtz, Ity; Eizenberg, Alon; Alkalay, Adi; Lahad, Amnon
• 署名单位: Ben-Gurion University of the Negev; Hebrew University of Jerusalem; Centre for Economic Policy Research - UK; Clalit Health Services
• 刊物名称: RAND JOURNAL OF ECONOMICS
• ISSN/ISSBN: 0741-6261
• DOI: 10.1111/1756-2171.12425
• 发表日期: 2022
• 页码: 763-791
• 关键词: nonparametric bounds; instrumental variables; health outcomes; incentives; returns; REFORM

摘要

Primary care is a notable example of a service industry where capacity-constrained suppliers face fluctuating demand levels. To meet this challenge, physicians trade off their time with patients with other inputs such as lab tests and referrals. We study this tradeoff using administrative data from a large Israeli HMO where the absence of colleagues generates exogenous variation in physician workload. We motivate and estimate a range of specifications, from a classic exclusion restriction within a linear model to non-parametric, partially identified models. The results suggest that diagnostic inputs are unlikely to properly compensate for a decline in time spent with patients.