Department of Economics, Deakin university, 70 Elgar Road, Burwood, VIC 3125, Australia.
Ruhr Graduate School in Economics, Germany; CINCH-Health Economics Research Center, Germany.
J Health Econ. 2023 May;89:102741. doi: 10.1016/j.jhealeco.2023.102741. Epub 2023 Mar 4.
We study how physicians' practice environments affect their treatment decisions and quality of care. Using clinical registry data from Sweden, we compare stent choices of cardiologists moving across hospitals over time. To disentangle changes in practice styles attributable to hospital- and peer group-specific factors, we exploit quasi-random variation on cardiologists working together on the same days. We find that migrating cardiologists' stent choices rapidly adapt to their new practice environment after relocation and are equally driven by the hospital and peer environments. In contrast, while decision errors increase, treatment costs and adverse clinical events remain largely unchanged despite the altered practice styles.
我们研究医生的执业环境如何影响他们的治疗决策和医疗质量。我们使用瑞典的临床注册数据，比较了随着时间的推移在不同医院之间流动的心脏病专家的支架选择。为了厘清归因于医院和同侪群体特定因素的实践风格变化，我们利用心脏病专家在同一天一起工作的准随机变化。我们发现，迁移后的心脏病专家的支架选择在重新安置后迅速适应新的执业环境，并且同样受到医院和同侪环境的驱动。相比之下，尽管实践风格发生了变化，但决策错误增加了，治疗成本和不良临床事件基本保持不变。
