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How does workload affect test ordering behavior of physicians? An empirical investigation

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  • Büşra Ergün‐Şahin
  • Evrim Didem Güneş
  • Ayşe Kocabıyıkoğlu
  • Ahmet Keskin

Abstract

We study the relationship between workload and the test ordering behavior of physicians in an operational context where examination can be finished with a test order. We define workload in two forms: the unfinished workload, that is, the work waiting to be completed, and the finished workload, that is, the already completed work since the beginning of the work day. We investigate their effect on the probability of a test order and the number of tests ordered for a patient who receives a test order. Empirical analysis of data from a public research and training hospital shows that these workload measures have different effects: A higher unfinished workload increases the probability of giving a test order, while a higher finished load decreases the number of tests ordered for those patients who receive a test order. The observed effects of the operational factors workload and finished load, which have no relation to the patients' complaints and hence, should have no bearing on the eventual diagnosis, and have significant implications for the quality and cost of health care. We also observe that the control variable, examination time, has a significant negative effect on the likelihood of ordering and the number of tests. We report the results of several robustness tests, which confirm our results.

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  • Büşra Ergün‐Şahin & Evrim Didem Güneş & Ayşe Kocabıyıkoğlu & Ahmet Keskin, 2022. "How does workload affect test ordering behavior of physicians? An empirical investigation," Production and Operations Management, Production and Operations Management Society, vol. 31(6), pages 2664-2680, June.
    • Handle: RePEc:bla:popmgt:v:31:y:2022:i:6:p:2664-2680
    DOI: 10.1111/poms.13711
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    References listed on IDEAS

    as
    1. Hummy Song & Anita L. Tucker & Karen L. Murrell & David R. Vinsonc, 2018. "Closing the Productivity Gap: Improving Worker Productivity Through Public Relative Performance Feedback and Validation of Best Practices," Management Science, INFORMS, vol. 64(6), pages 2628-2649, June.
    2. Tom Fangyun Tan & Serguei Netessine, 2014. "When Does the Devil Make Work? An Empirical Study of the Impact of Workload on Worker Productivity," Management Science, INFORMS, vol. 60(6), pages 1574-1593, June.
    3. Robert J. Batt & Christian Terwiesch, 2017. "Early Task Initiation and Other Load-Adaptive Mechanisms in the Emergency Department," Management Science, INFORMS, vol. 63(11), pages 3531-3551, November.
    4. David C. Chan, 2018. "The Efficiency of Slacking off: Evidence From the Emergency Department," Econometrica, Econometric Society, vol. 86(3), pages 997-1030, May.
    5. Kenneth L. Schultz & David C. Juran & John W. Boudreau & John O. McClain & L. Joseph Thomas, 1998. "Modeling and Worker Motivation in JIT Production Systems," Management Science, INFORMS, vol. 44(12-Part-1), pages 1595-1607, December.
    6. Tinglong Dai & Shubhranshu Singh, 2020. "Conspicuous by Its Absence: Diagnostic Expert Testing Under Uncertainty," Marketing Science, INFORMS, vol. 39(3), pages 540-563, May.
    7. Saed Alizamir & Francis de Véricourt & Peng Sun, 2013. "Diagnostic Accuracy Under Congestion," Management Science, INFORMS, vol. 59(1), pages 157-171, December.
    8. Delasay, Mohammad & Ingolfsson, Armann & Kolfal, Bora & Schultz, Kenneth, 2019. "Load effect on service times," European Journal of Operational Research, Elsevier, vol. 279(3), pages 673-686.
    9. Leemore S. Dafny, 2005. "How Do Hospitals Respond to Price Changes?," American Economic Review, American Economic Association, vol. 95(5), pages 1525-1547, December.
    10. Cragg, John G, 1971. "Some Statistical Models for Limited Dependent Variables with Application to the Demand for Durable Goods," Econometrica, Econometric Society, vol. 39(5), pages 829-844, September.
    11. Maria R. Ibanez & Michael W. Toffel, 2020. "How Scheduling Can Bias Quality Assessment: Evidence from Food-Safety Inspections," Management Science, INFORMS, vol. 66(6), pages 2396-2416, June.
    12. Silverman, Elaine & Skinner, Jonathan, 2004. "Medicare upcoding and hospital ownership," Journal of Health Economics, Elsevier, vol. 23(2), pages 369-389, March.
    13. Michael Freeman & Nicos Savva & Stefan Scholtes, 2017. "Gatekeepers at Work: An Empirical Analysis of a Maternity Unit," Management Science, INFORMS, vol. 63(10), pages 3147-3167, October.
    14. Tinglong Dai & Mustafa Akan & Sridhar Tayur, 2017. "Imaging Room and Beyond: The Underlying Economics Behind Physicians’ Test-Ordering Behavior in Outpatient Services," Manufacturing & Service Operations Management, INFORMS, vol. 19(1), pages 99-113, February.
    15. Ludwig Kuntz & Roman Mennicken & Stefan Scholtes, 2015. "Stress on the Ward: Evidence of Safety Tipping Points in Hospitals," Management Science, INFORMS, vol. 61(4), pages 754-771, April.
    16. Sarang Deo & Aditya Jain, 2019. "Slow First, Fast Later: Temporal Speed‐Up in Service Episodes of Finite Duration," Production and Operations Management, Production and Operations Management Society, vol. 28(5), pages 1061-1081, May.
    17. Jillian A. Berry Jaeker & Anita L. Tucker, 2017. "Past the Point of Speeding Up: The Negative Effects of Workload Saturation on Efficiency and Patient Severity," Management Science, INFORMS, vol. 63(4), pages 1042-1062, April.
    18. Rogelio Oliva & John D. Sterman, 2001. "Cutting Corners and Working Overtime: Quality Erosion in the Service Industry," Management Science, INFORMS, vol. 47(7), pages 894-914, July.
    19. Diwas Singh KC & Christian Terwiesch, 2012. "An Econometric Analysis of Patient Flows in the Cardiac Intensive Care Unit," Manufacturing & Service Operations Management, INFORMS, vol. 14(1), pages 50-65, January.
    20. Tinglong Dai & Mustafa Akan & Sridhar Tayur, 2017. "Imaging Room and Beyond: The Underlying Economics Behind Physicians’ Test-Ordering Behavior in Outpatient Services," Manufacturing & Service Operations Management, INFORMS, vol. 19(1), pages 99-113, February.
    21. Diwas S. Kc & Christian Terwiesch, 2009. "Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations," Management Science, INFORMS, vol. 55(9), pages 1486-1498, September.
    22. Lauren F. Laker & Craig M. Froehle & Jaime B. Windeler & Christopher John Lindsell, 2018. "Quality and Efficiency of the Clinical Decision‐Making Process: Information Overload and Emphasis Framing," Production and Operations Management, Production and Operations Management Society, vol. 27(12), pages 2213-2225, December.
    23. Adam Powell & Sergei Savin & Nicos Savva, 2012. "Physician Workload and Hospital Reimbursement: Overworked Physicians Generate Less Revenue per Patient," Manufacturing & Service Operations Management, INFORMS, vol. 14(4), pages 512-528, October.
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