Molitor David
University of Illinois at Urbana-Champaign, 1206 S. Sixth Street, Champaign, IL 61820 and National Bureau of Economic Research (NBER).
Am Econ J Econ Policy. 2018 Feb;10(1):326-356. doi: 10.1257/pol.20160319.
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.
对于明显相似的患者，医生的治疗选择在不同地区差异巨大。本文利用心脏病专家的迁移来厘清医生特定因素（如偏好和习得行为）与环境层面因素（如医院容量和生产率溢出效应）对医生行为的作用。起始于同一地区、随后迁移至不同地区的医生在迁移前行为相似。迁移后，实践环境每变化一个百分点，医生在第一年的行为就会改变0.6至0.8个百分点，且随着时间推移不再有进一步变化。这表明环境因素解释了医生行为中60%至80%的地区差异。
