Working Paper: NBER ID: w26269
Authors: Itzik Fadlon; Jessica N. Van Parys
Abstract: Primary care physicians (PCPs) provide frontline health care to patients in the U.S.; however, it is unclear how their practice styles affect patient care. In this paper, we estimate the long-lasting effects of PCP practice styles on patient health care utilization by focusing on Medicare patients affected by PCP relocations or retirements, which we refer to as "exits." Observing where patients receive care after these exits, we estimate event studies to compare patients who switch to PCPs with different practice style intensities. We find that PCPs have large effects on a range of aggregate utilization measures, including physician and outpatient spending and the number of diagnosed conditions. Moreover, we find that PCPs have large effects on the quality of care that patients receive, and that all of these effects persist for several years. Our results suggest that switching to higher-quality PCPs could significantly affect patients' longer-run health outcomes.
Keywords: Primary Care; Health Care Utilization; Medicare; Physician Practice Styles
JEL Codes: I11; I13; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| PCP exits (P30) | switching to new PCPs with different practice styles (I11) |
| PCP practice styles (I11) | patient health care utilization (I11) |
| switching to a PCP with higher practice style intensity (I11) | increases in physician spending (I11) |
| switching to a PCP with higher practice style intensity (I11) | increases in outpatient spending (H51) |
| switching to a PCP with higher practice style intensity (I11) | increases in the number of diagnosed conditions (I12) |
| switching to PCPs with vaccination rates 10 percentage points higher (I14) | likelihood of receiving flu vaccinations increases (I14) |