Department of Economics, Johannes Kepler University Linz, Austria.
Christian Doppler Laboratory Aging, Health, and the Labor Market, Austria.
Health Econ. 2020 Jun;29(6):683-699. doi: 10.1002/hec.4011. Epub 2020 Feb 20.
Variations in medical resource usage, both across and within geographical regions, have been widely documented. In this paper, we explore physician practice styles as a possible determinant of these variations. In particular, we exploit patient mobility between physicians to identify practice styles among general practitioners (GPs) in Austria. We use a large administrative data set containing detailed information on a battery of different health-care services and implement a model with additive patient and GP fixed effects that allows flexibly for systematic differences in patients' health states. We find that, although GPs explain only a small part of the overall variation in medical expenses, heterogeneities in spending patterns among GPs are substantial. Conditional on patient characteristics, we document a difference of € 751.47 per patient per year in total medical expenses (which amounts to roughly 45% of the sample mean) between high- and low-spending GPs.
医疗资源的使用在地域间和地域内都存在广泛的差异。在本文中,我们探讨了医生的行医风格是否是导致这些差异的一个可能因素。具体来说,我们利用医生之间的患者流动来识别奥地利全科医生(GP)的行医风格。我们使用了一个包含详细信息的大型行政数据集,其中包括一系列不同的医疗服务,并实施了一个具有加性患者和 GP 固定效应的模型,该模型可以灵活地考虑患者健康状况的系统差异。我们发现,尽管全科医生仅能解释医疗费用总变异的一小部分,但全科医生的支出模式存在很大的异质性。在考虑了患者特征的情况下,我们记录了高支出和低支出 GP 之间每位患者每年的总医疗费用差异为 751.47 欧元(约占样本平均值的 45%)。