Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians

• 成果类型: Article
• 署名作者: Currie, Janet; MacLeod, W. Bentley
• 署名单位: Princeton University; National Bureau of Economic Research; Columbia University
• 刊物名称: JOURNAL OF LABOR ECONOMICS
• ISSN/ISSBN: 0734-306X
• DOI: 10.1086/687848
• 发表日期: 2017
• 页码: 1-43
• 关键词: cesarean-section; health-care; incentives; INFORMATION; liability; QUALITY; REFORM

摘要

Expert performance is often evaluated assuming that good experts have good outcomes. We examine expertise in medicine and develop a model that allows for two dimensions of physician performance: decision making and procedural skill. Better procedural skill increases the use of intensive procedures for everyone, while better decision making results in a reallocation of procedures from fewer low-risk to high-risk cases. We show that poor diagnosticians can be identified using administrative data and that improving decision making improves birth outcomes by reducing C-section rates at the bottom of the risk distribution and increasing them at the top of the distribution.