The Productivity of Professions: Evidence from the Emergency Department

• 成果类型: Article
• 署名作者: Chan, David; Chen, Yiqun
• 署名单位: University of California System; University of California Berkeley; National Bureau of Economic Research; University of Illinois System; University of Illinois Chicago; University of Illinois Chicago Hospital
• 刊物名称: AMERICAN ECONOMIC REVIEW
• ISSN/ISSBN: 0002-8282; 1944-7981
• DOI: 10.1257/aer.20241007
• 发表日期: 2026-08
• 页码: 2883-2927
• 关键词: NURSE-PRACTITIONERS; moral hazard; care; allocation; variables; teachers; guide

摘要

This paper studies the productivity of nurse practitioners (NPs) and physicians, two professions performing overlapping tasks but with starkly different backgrounds, training, and pay. Using quasi-experimental variation inpatient assignment to NPs versus physicians in Veterans Health Administration emergency departments, we find that, on average, NPs use more resources and exhibit a higher 30-day preventable hospitalization rate than physicians. However, the NP-physician performance difference varies by case complexity and severity. Importantly, even larger productivity variation exists within each profession, leading to substantial overlap between the productivity distributions of the two professions; NPs outperform physicians in 38 percent of random pairs. (JEL I11, I18, J24, J44, M53)