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Providers, peers and patients. How do physicians’ practice environments affect patient outcomes?

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  • Avdic, Daniel
  • Ivets, Maryna
  • Lagerqvist, Bo
  • Sriubaite, Ieva

Abstract

We study how physicians’ practice environments affect their treatment decisions and quality of care. Using clinical registry data from Sweden, we compare stent choices of cardiologists moving across hospitals over time. To disentangle changes in practice styles attributable to hospital- and peer group-specific factors, we exploit quasi-random variation on cardiologists working together on the same days. We find that migrating cardiologists’ stent choices rapidly adapt to their new practice environment after relocation and are equally driven by the hospital and peer environments. In contrast, while decision errors increase, treatment costs and adverse clinical events remain largely unchanged despite the altered practice styles.

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  • Avdic, Daniel & Ivets, Maryna & Lagerqvist, Bo & Sriubaite, Ieva, 2023. "Providers, peers and patients. How do physicians’ practice environments affect patient outcomes?," Journal of Health Economics, Elsevier, vol. 89(C).
  • Handle: RePEc:eee:jhecon:v:89:y:2023:i:c:s0167629623000188
    DOI: 10.1016/j.jhealeco.2023.102741
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    1. Fischer, Martin & Karlsson, Martin & Prodromidis, Nikolaos, 2021. "Long‐term Effects of Hospital Deliveries," CINCH Working Paper Series (since 2020) 74712, Duisburg-Essen University Library, DuEPublico.

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    More about this item

    Keywords

    Practice style; Environment; Peers; Quality of care;
    All these keywords.

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis
    • D91 - Microeconomics - - Micro-Based Behavioral Economics - - - Role and Effects of Psychological, Emotional, Social, and Cognitive Factors on Decision Making
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • O33 - Economic Development, Innovation, Technological Change, and Growth - - Innovation; Research and Development; Technological Change; Intellectual Property Rights - - - Technological Change: Choices and Consequences; Diffusion Processes

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