Physician Quality and Health Care for the Poor and Uninsured

Many studies have documented adverse health outcomes for uninsured patients in U.S. hospitals. These poor outcomes have been attributed to their health status and limited access to healthcare. A measure of treatment that remains unexplored is the quality of the physicians treating uninsured patients. We examine whether uninsured and poor patients are treated by lower quality physicians with four measures of physician quality. Using a hospital fixed-effects model, we find that cardiac patients are matched to physician quality based on their ability to pay. Even after controlling for average physician quality within a hospital and patient characteristics, we find that uninsured and Medicaid patients are generally treated by lower quality physicians. We also find that while for-profit and not-for-profit hospitals treat the uninsured with lower quality physicians, government hospitals do not. However, there is evidence that hospitals of all ownership types treat Medicaid patients with lower quality physicians.