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谁会对较长的等待时间做出反应?预测的紧急等待时间对前来就诊的患者的健康和数量的影响。

Who responds to longer wait times? The effects of predicted emergency wait times on the health and volume of patients who present for care.

机构信息

Division of Health Policy and Economics, Population Health Sciences, Weill Cornell Medicine, New York, NY.

出版信息

J Health Econ. 2024 Jun;96:102898. doi: 10.1016/j.jhealeco.2024.102898. Epub 2024 May 21.

Abstract

Healthcare is often free at the point-of-care so that price does not deter patients. However, the dis-utility from waiting for care that often occurs could also lead to deterrence. I investigate responses in the volume and types of patients that demand emergency care when predicted waiting times quasi-randomly change. I leverage a discontinuity to compare emergency sites with similar predicted wait times but with different apparent wait times displayed to patients. I use impulse response functions estimated by local projections to estimate effects of predicted wait times on patient demand for care. An additional thirty minutes of predicted wait time results in 15% fewer waiting patients at urgent cares and 2% fewer waiting patients at emergency departments within three hours of display. Patients that stop using emergency care are also triaged as healthier. However, at very high predicted wait times, there are reductions in demand for all patients including sicker patients.

摘要

在提供医疗服务时,通常是免费的,因此价格不会阻止患者接受治疗。然而,由于等待治疗而产生的不便利也可能导致患者望而却步。我调查了当预测等待时间准随机变化时,对紧急护理的需求数量和类型的反应。我利用一种不连续性,将具有相似预测等待时间但向患者显示不同的明显等待时间的紧急护理场所进行比较。我使用局部投影估计的脉冲响应函数来估计预测等待时间对患者护理需求的影响。预测等待时间增加三十分钟,在显示后三小时内,紧急护理中心的等候患者减少 15%,急诊部的等候患者减少 2%。停止使用急诊护理的患者也被分诊为更健康。然而,在预测等待时间非常高的情况下,所有患者(包括病情较重的患者)的需求都会减少。

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