Schnell Molly, Currie Janet
Princeton University, Department of Economics, Julis Romo Rabinowitz Building, Princeton, NJ 08544.
Department of Economics, Center for Health and Wellbeing, 185A Julis Romo Rabinowitz Building, Princeton University, Princeton, NJ 08544, and NBER.
Am J Health Econ. 2018 Summer;4(3):383-410. doi: 10.1162/ajhe_a_00113. Epub 2018 Aug 17.
Using national data on opioid prescriptions written by physicians from 2006 to 2014, we uncover a striking relationship between opioid prescribing and medical school rank. Even within the same specialty and practice location, physicians who completed their initial training at top medical schools write significantly fewer opioid prescriptions annually than physicians from lower ranked schools. Additional evidence suggests that some of this gradient represents a causal effect of education rather than patient selection across physicians or physician selection across medical schools. Altering physician education may therefore be a useful policy tool in fighting the current epidemic.
利用2006年至2014年医生开具阿片类药物处方的全国数据，我们发现阿片类药物处方与医学院校排名之间存在显著关系。即使在相同专业和执业地点内，在顶尖医学院完成初始培训的医生每年开具的阿片类药物处方也明显少于排名较低院校的医生。更多证据表明，这种梯度差异部分代表了教育的因果效应，而非医生间的患者选择差异或医学院校间的医生选择差异。因此，改变医生教育可能是应对当前这一流行病的一项有用政策工具。
