Who cares when you close down? The effects of primary care practice closures on patients
| Autor: | Tamara Bischof, Boris Kaiser |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Health plan
medicine.medical_specialty Primary care Adverse health effect General Practitioners Health care medicine ddc:330 Humans D12 I31 Health policy Primary Care Primary Health Care business.industry I11 Health Policy I12 Continuity of Care 330 Economics Healthcare utilization Family medicine Ambulatory Healthcare Expenditures Female Continuity of care Health Expenditures Healthcare Utilization business Delivery of Health Care Specialization |
| Zdroj: | Bischof, Tamara; Kaiser, Boris (2019). Who Cares When You Close Down? The Effects of Primary Care Practice Closures on Patients (Unpublished) (Discussion Papers 19-07). Bern: Department of Economics |
| DOI: | 10.48350/161769 |
| Popis: | This paper investigates the consequences that patients face when their regular general practitioner (GP) closes down her practice, typically due to retirement. We estimate the causal impact of closures on patients' utilization patterns, healthcare expenditures, hospitalizations, mortality, and health plan choices. Employing a difference-in-difference framework, we find that patients who experience a discontinuity of care persistently adjust their ambulatory utilization pattern by shifting visits away from GPs (���12%) toward specialists (+11%) and hospital outpatient facilities (+6%). In contrast, we find no evidence on adverse health effects as measured by hospitalizations and mortality. The impact on utilization is heterogeneous along several dimensions. In particular, we find geographic disparities between regions with high and low availability of primary care. We also observe that patients with chronic conditions substitute more strongly toward other providers. Our results have potential implications for health policy in at least two dimensions: first, practice closures lead to more fragmented care which may entail inefficiencies, and second, closures deteriorate access to primary care in regions with low physician density. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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