University of Oslo, Department of Health Management and Health Economics, P.O. Box 1089, Blindern, NO-0317 Oslo, Norway.
J Health Econ. 2011 Sep;30(5):894-903. doi: 10.1016/j.jhealeco.2011.07.008. Epub 2011 Jul 19.
Patients switching physicians involves costs to the patients because of less continuity of care. From a theoretical model we derive that inferior physician quality as perceived by patients, implies patient shortage for the physician and more patients switching physicians. By means of a unique panel data set covering the entire population of Norwegian general practitioners (GPs) and estimation methods that adjust for potential endogeneities, we find that the occurrence of patient shortage increases the proportion of patients switching physicians by 50%. A competing hypothesis that GPs with a shortage of patients experience less switching because of superior access is rejected by data. To assist patients in making informed decisions, we suggest that the number of switches a physician experiences should be made public.
患者更换医生会导致患者的成本增加，因为这会导致医疗护理的连续性降低。我们从一个理论模型中得出，患者认为医生的质量较差，这意味着医生的患者短缺，更多的患者会更换医生。通过一个涵盖挪威全科医生（GP）全体人群的独特面板数据集和调整潜在内生性的估计方法，我们发现患者短缺的发生会使更换医生的患者比例增加 50%。我们的数据否定了一个竞争假说，即由于获得途径较好，患者短缺的全科医生经历的更换行为会更少。为了帮助患者做出明智的决策，我们建议应公开医生经历的更换次数。
