Indiana University, United States.
University of Minnesota, United States.
J Health Econ. 2021 May;77:102442. doi: 10.1016/j.jhealeco.2021.102442. Epub 2021 Feb 23.
This paper examines how time pressure, an important constraint faced by medical care providers, affects productivity in primary care. We generate empirical predictions by incorporating time pressure into a model of physician behavior by Tai-Seale and McGuire (2012). We use data from the electronic health records of a large integrated delivery system and leverage unexpected schedule changes as variation in time pressure. We find that greater time pressure reduces the number of diagnoses recorded during a visit and increases both scheduled and unscheduled follow-up care. We also find some evidence of increased low-value care, decreased preventive care, and decreased opioid prescribing.
本文考察了时间压力（医疗服务提供者面临的一个重要约束）如何影响初级保健的生产力。我们通过将时间压力纳入 Tai-Seale 和 McGuire（2012）的医生行为模型来生成经验预测。我们使用来自大型综合交付系统的电子健康记录数据，并利用意外的日程变更作为时间压力的变化。我们发现，更大的时间压力会减少就诊期间记录的诊断数量，并增加计划内和计划外的随访护理。我们还发现一些增加低价值护理、减少预防保健和减少阿片类药物处方的证据。
