Working Paper: NBER ID: w31033
Authors: Zach Y. Brown; Christopher Hansman; Jordan Keener; Andre F. Veiga
Abstract: Why do low income patients tend to go to lower quality health care providers, even when they are free? We show that differential information about provider quality is an important determinant of this disparity. Our empirical strategy exploits the temporary presence of a website that publicly displayed summary star ratings of general practitioner (GP) offices in England. Regression discontinuity estimates show that patient demand responds sharply to the information on the website, and that this response is almost entirely driven by residents of low income neighborhoods. The results are consistent with high income patients having better private information about quality. We incorporate our estimates into a structural model of demand that allows for heterogeneity in information, preferences, and consumer inertia. We find that information differences explain 24 percent of the relationship between income and GP quality and reinforce disparities in access to care.
Keywords: health care quality; GP choice; information disparities; income inequality
JEL Codes: D83; I11; I14; L15
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| low-income patients (I32) | respond sharply to star ratings (C52) |
| respond sharply to star ratings (C52) | choice of GP quality (C52) |
| information disparities (I24) | relationship between income and GP quality (I14) |
| high-income patients (I11) | less influenced by star ratings (Y30) |
| high-income patients (I11) | responsive to subtle differences in quality (L15) |