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Discontinuity in care: Practice closures among primary care providers and patient health care utilization

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  • Simonsen, Marianne
  • Skipper, Lars
  • Skipper, Niels
  • Thingholm, Peter Rønø

Abstract

We evaluate the consequences for patients of being matched to a new primary care provider due to practice closures. Using an event study and population-level data of patients and providers in Denmark, we find that the transition between providers is smooth; among re-matched patients, there is little change in primary care utilization at the extensive margin. Second, we document a 17% increase in fee-for-service per visit and a large increase in the probability that the patient initiates drug therapy targeting chronic and underdiagnosed diseases (hypertension, hyperlipidemia, and diabetes). Additionally, the re-matched patients are more likely to be admitted to inpatient care for these diseases. The increase in therapeutic initiation is not primarily because the new providers are relatively predisposed to prescribing these drugs. Instead, it appears that when patients match to new providers, there is a consequential reassessment of patients’ medical needs which leads to the initiation of new treatment.

Suggested Citation

  • Simonsen, Marianne & Skipper, Lars & Skipper, Niels & Thingholm, Peter Rønø, 2021. "Discontinuity in care: Practice closures among primary care providers and patient health care utilization," Journal of Health Economics, Elsevier, vol. 80(C).
  • Handle: RePEc:eee:jhecon:v:80:y:2021:i:c:s0167629621001363
    DOI: 10.1016/j.jhealeco.2021.102551
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    Cited by:

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    2. 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).
    3. Zhang, Xuan, 2022. "The effects of physician retirement on patient outcomes: Anticipation and disruption," Journal of Public Economics, Elsevier, vol. 207(C).
    4. Katrin Zocher, 2024. "Exiting primary care providers," Health Economics, John Wiley & Sons, Ltd., vol. 33(5), pages 1033-1054, May.
    5. Gerald J. Pruckner & Flora Stiftinger & Katrin Zocher, 2024. "When women take over: Physician gender and health care provision," Economics working papers 2024-04, Department of Economics, Johannes Kepler University Linz, Austria.
    6. Wu, Yansi, 2023. "Impacts of Interpersonal Continuity between General Practitioners (GPs) and Patients on Health Outcomes: A Systematic Review," HERO Online Working Paper Series 2023:2, University of Oslo, Health Economics Research Programme.
    7. Ida Lykke Kristiansen & Sophie Yanying Sheng, 2022. "Doctor Who? The Effect of Physician-Patient Match on The SES-Health Gradient," CEBI working paper series 22-05, University of Copenhagen. Department of Economics. The Center for Economic Behavior and Inequality (CEBI).
    8. Sabety, Adrienne, 2023. "The value of relationships in healthcare," Journal of Public Economics, Elsevier, vol. 225(C).
    9. Stefan Sliwa Ruiz & Malte Becker & Thomas Hone & Rudi Rocha, 2023. "Doctor Turnover and Health Outcomes: Evidence from the Exit of Cuban Doctors in Brazil," Working Papers 18, Instituto de Estudos para Políticas de Saúde.
    10. Shan Huang & Hannes Ullrich, 2023. "Provider effects in antibiotic prescribing: Evidence from physician exits," Berlin School of Economics Discussion Papers 0018, Berlin School of Economics.

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    More about this item

    Keywords

    Physician practice closure; Disruption; Practice styles;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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