The Evolution of Physician Practice Styles: Evidence from Cardiologist Migration

• 成果类型: Article
• 署名作者: Molitor, David
• 署名单位: University of Illinois System; University of Illinois Urbana-Champaign; National Bureau of Economic Research
• 刊物名称: AMERICAN ECONOMIC JOURNAL-ECONOMIC POLICY
• ISSN/ISSBN: 1945-7731
• DOI: 10.1257/pol.20160319
• 发表日期: 2018
• 页码: 326-356
• 关键词: regional-variations; health-care; myocardial-infarction; coronary-angiography; geographic-variation; patient; preferences; intensity; QUALITY

摘要

Physician treatment choices for observably similar patients vary dramatically across regions. This paper exploits cardiologist migration to disentangle the role of physician-specific factors such as preferences and learned behavior versus environment-level factors such as hospital capacity and productivity spillovers on physician behavior. Physicians starting in the same region and subsequently moving to dissimilar regions practice similarly before the move. After the move, physician behavior in the first year changes by 0.6-0.8 percentage points for each percentage point change in practice environment, with no further changes over time. This suggests environment factors explain between 60-80 percent of regional disparities in physician behavior.