Pruckner Gerald J, Stiftinger Flora, Zocher Katrin
Department of Economics, Johannes Kepler University Linz, Austria.
Department of Economics, Johannes Kepler University Linz, Austria.
J Health Econ. 2025 Aug;102:103000. doi: 10.1016/j.jhealeco.2025.103000. Epub 2025 May 10.
The share of female physicians has risen in OECD countries in recent decades, but we know little about the effects of physician gender on patient health care use. We exploit quasi-random assignment of primary care providers (PCPs) to existing PCP practices and patients and estimate the causal effect of female PCPs on health care provision. Using Austrian register data and a difference-in-differences strategy, we find that female PCPs generate 15% less revenue and see 7% fewer patients than male PCPs. Shifting the focus to patient-level outcomes, we observe that health care utilization remains largely unchanged following assignment to a female physician. However, results show that patients are more likely to leave PCP practices with female successors. Our results do not support the idea that the decision to change PCP is driven by preferences against being treated by female physicians. Instead, our analysis suggests that the observed differences are partly explained by female PCPs working fewer hours, especially those facing working time restrictions. As the share of female physicians continues to rise, measures to increase work flexibility may be necessary to maintain broad access to outpatient health care.
近几十年来，经合组织国家女医生的比例有所上升，但我们对医生性别对患者医疗保健使用的影响知之甚少。我们利用初级保健提供者（PCP）被准随机分配到现有PCP诊所和患者的情况，估计女PCP对医疗保健提供的因果效应。利用奥地利的登记数据和差分策略，我们发现女PCP产生的收入比男PCP少15%，看诊的患者比男PCP少7%。将重点转向患者层面的结果，我们观察到在被分配给女医生后，医疗保健利用率基本保持不变。然而，结果表明，患者更有可能离开有女继任者的PCP诊所。我们的结果不支持更换PCP的决定是由对女医生治疗的偏好驱动这一观点。相反，我们的分析表明，观察到的差异部分是由女PCP工作时间较少造成的，尤其是那些面临工作时间限制的女PCP。随着女医生比例持续上升，可能需要采取措施提高工作灵活性，以维持广泛的门诊医疗服务可及性。
