Working Paper: NBER ID: w30608
Authors: David C. Chan Jr.; Yiqun Chen
Abstract: This paper studies the productivity of nurse practitioners (NPs) and physicians, two professions performing overlapping tasks but with starkly different backgrounds, training, and pay. Using quasi-experimental variation in patient assignment to NPs versus physicians in Veterans Health Administration emergency departments, we find that, on average, NPs use more resources and achieve less favorable patient outcomes than physicians. However, the NP-physician performance difference varies by case complexity and severity. Importantly, even larger productivity variation exists within each profession, leading to substantial overlap between the productivity distributions of the two professions; NPs perform better than physicians in 38 percent of random pairs.
Keywords: nurse practitioners; physicians; productivity; emergency department; healthcare
JEL Codes: I11; I18; J24; J44; M53
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| NPs (H59) | patient length of stay (I11) |
| NPs (H59) | cost of ED care (I10) |
| NPs (H59) | 30-day preventable hospitalizations (I13) |
| patient complexity (I11) | NP-physician productivity gap (I11) |
| experience (Y60) | NP-physician productivity gap (I11) |