TY - JOUR
T1 - Provider practice style and patient health outcomes
T2 - The case of heart attacks
AU - Currie, Janet
AU - MacLeod, W. Bentley
AU - Van Parys, Jessica
N1 - Funding Information:
The authors gratefully acknowledge the Florida Agency for Health Care Administration (AHCA) for supplying the data and Dr. Andrew Doorey, Dr. Shunichi Homma, participants at the June 2015 Society of Labor Economists conference, and two anonymous referees for helpful comments.
Publisher Copyright:
© 2016 Elsevier B.V.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), the provider on duty must quickly decide how aggressively the patient should be treated. Using Florida data on all such patients from 1992 to 2014, we decompose practice style into two components: The provider's probability of conducting invasive procedures on the average patient (which we characterize as aggressiveness), and the responsiveness of the choice of procedure to the patient's characteristics. We show that within hospitals and years, patients with more aggressive providers have consistently higher costs and better outcomes. Since all patients benefit from higher utilization of invasive procedures, targeting procedure use to the most appropriate patients benefits these patients at the expense of the less appropriate patients. We also find that the most aggressive and responsive physicians are young, male, and trained in top 20 schools.
AB - When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), the provider on duty must quickly decide how aggressively the patient should be treated. Using Florida data on all such patients from 1992 to 2014, we decompose practice style into two components: The provider's probability of conducting invasive procedures on the average patient (which we characterize as aggressiveness), and the responsiveness of the choice of procedure to the patient's characteristics. We show that within hospitals and years, patients with more aggressive providers have consistently higher costs and better outcomes. Since all patients benefit from higher utilization of invasive procedures, targeting procedure use to the most appropriate patients benefits these patients at the expense of the less appropriate patients. We also find that the most aggressive and responsive physicians are young, male, and trained in top 20 schools.
KW - Aggressiveness
KW - Heart attack
KW - Provider practice style
KW - Responsiveness
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U2 - 10.1016/j.jhealeco.2016.01.013
DO - 10.1016/j.jhealeco.2016.01.013
M3 - Article
C2 - 26938940
AN - SCOPUS:84959421017
SN - 0167-6296
VL - 47
SP - 64
EP - 80
JO - Journal of Health Economics
JF - Journal of Health Economics
ER -