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Who Cares When You Close Down? The Effects of Primary Care Practice Closures on Patients

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  • Tamara Bischof
  • Boris Kaiser

Abstract

This paper investigates the consequences that patients face when their regular primary care provider closes down her practice, typically due to retirement. We estimate the causal impact of closures on patients utilization patterns, medical expenditures, hospitalizations, and health plan choice. Employing a difference-in-difference framework, we find that patients who experience a discontinuity of care persistently adjust their utilization pattern by shifting visits away from ambulatory primary care providers (-12%) towards specialist care (+10%), and hospital outpatient facilities (+5%). The magnitude of these effects depends considerably on the local availability of primary care. We also observe that patients with chronic conditions shift their utilization more strongly towards other providers. Our results have potential implications for health policy in at least two dimensions: practice closures may lead to an inefficient use of healthcare services and deteriorate access to primary care, particularly in regions where the supply of primary care doctors is low.

Suggested Citation

  • Tamara Bischof & Boris Kaiser, 2019. "Who Cares When You Close Down? The Effects of Primary Care Practice Closures on Patients," Diskussionsschriften dp1907, Universitaet Bern, Departement Volkswirtschaft.
    • Handle: RePEc:ube:dpvwib:dp1907
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    Cited by:

    1. Hjalmarsson, Linn & Kaiser, Boris & Bischof, Tamara, 2023. "The impact of physician exits in primary care: A study of practice handovers," Health Policy, Elsevier, vol. 135(C).
    2. Anikó Bíró & Blanka Imre, 2022. "Financial subsidies and the shortage of primary care physicians," CERS-IE WORKING PAPERS 2210, Institute of Economics, Centre for Economic and Regional Studies.
    3. Zhang, Xuan, 2022. "The effects of physician retirement on patient outcomes: Anticipation and disruption," Journal of Public Economics, Elsevier, vol. 207(C).
    4. Zocher, Katrin, 2022. "Exiting primary care providers," EconStor Preprints 249041, ZBW - Leibniz Information Centre for Economics, revised 2022.
    5. Sabety, Adrienne, 2023. "The value of relationships in healthcare," Journal of Public Economics, Elsevier, vol. 225(C).

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    More about this item

    Keywords

    Continuity of Care; Healthcare Utilization; Healthcare Expenditures; Primary Care; General Practitioners;
    All these keywords.

    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I31 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - General Welfare, Well-Being

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