Returns to physician human capital Evidence from patients randomized to physician teams
Returns to physician human capital Evidence from patients randomized to physician teams
复制标题
DOI：
10.1016/j.jhealeco.2010.08.004
复制
发表时间：
2010-12-01
影响因子：
3.5
通讯作者：
Wagner, Todd H.
中科院分区：
文献类型：
--
作者：
Doyle, Joseph J., Jr.;Ewer, Steven M.;Wagner, Todd H.
医生扮演了重要的角色在决定医疗保健的成本和质量还估计这些影响可以通过患者困惑排序本文认为一个自然实验,近30 000名患者被随机分配到两个学术机构的临床团队从一个机构是美国最好的医学院校之一,而其他机构排名较低的患者分布的两个项目有类似的可观测的特点和获得一套设施和辅助人员治疗的医生更高的排名机构的10 - 25%更便宜比病人分配到较低的排名机构保持健康结果不相关的医师团队作业成本差异最为明显严重的条件和他们很大程度上源于诊断检测率较低的排名程序倾向于更多的测试,需要更长的时间,命令他们V (C) 2010爱思唯尔B版权所有
Physicians play a major role in determining the cost and quality of healthcare yet estimates of these effects can be confounded by patient sorting This paper considers a natural experiment where nearly 30 000 patients were randomly assigned to clinical teams from one of two academic institutions One institution is among the top medical schools in the U S while the other institution is ranked lower in the distribution Patients treated by the two programs have similar observable characteristics and have access to a single set of facilities and ancillary staff Those treated by physicians from the higher ranked institution have 10-25% less expensive stays than patients assigned to the lower ranked institution Health outcomes are not related to the physician team assignment Cost differences are most pronounced for serious conditions and they largely stem from diagnostic-testing rates the lower ranked program tends to order more tests and takes longer to order them (C) 2010 Elsevier B V All rights reserved