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Discrimination in Health Care: A Field Experiment on the Impact of Patients’ Socioeconomic Status on Access to Care

Author

Listed:
  • Silvia Angerer

    (UMIT—Private University for Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Healthcare)

  • Christian Waibel

    (ETH Zurich)

  • Harald Stummer

    (UMIT—Private University for Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Healthcare, University Seeburg Castle, Institut für Gesundheitsmanagement und Innovation)

Abstract

We employ a large-scale field experiment to investigate the impact of patients’ socioeconomic status on access to care. We request an appointment at more than 1,200 physicians in Austria, varying the educational level of the patient. Our results show that overall patients with a university degree receive an appointment significantly more often than patients without a degree. Differentiating between practice assistants and physicians as responders, we find that physicians provide significantly shorter response times and marginally significant shorter waiting times for appointments for patients with than without a university degree. Our results thus provide unambiguous evidence that discrimination by health providers contributes to the gradient in access to care. Furthermore, we argue that our results are consistent with implicit bias for practice assistants and statistical discrimination based on financial incentives for physicians.

Suggested Citation

  • Silvia Angerer & Christian Waibel & Harald Stummer, 2019. "Discrimination in Health Care: A Field Experiment on the Impact of Patients’ Socioeconomic Status on Access to Care," American Journal of Health Economics, University of Chicago Press, vol. 5(4), pages 407-427, Fall.
  • Handle: RePEc:ucp:amjhec:v:5:y:2019:i:4:p:407-427
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    Cited by:

    1. Werbeck, Anna & Wübker, Ansgar & Ziebarth, Nicolas R., 2021. "Cream skimming by health care providers and inequality in health care access: Evidence from a randomized field experiment," Journal of Economic Behavior & Organization, Elsevier, vol. 188(C), pages 1325-1350.
    2. Rita Ginja & Julie Riise & Barton Willage & Alexander Willén, 2025. "Does Your Doctor Matter?," Journal of Political Economy Microeconomics, University of Chicago Press, vol. 3(3), pages 497-538.
    3. Omry Yoresh & Weijian Zou, 2026. "The lifecycle of judicial bias," CEP Discussion Papers dp2159, Centre for Economic Performance, LSE.
    4. Luca Fumarco & Benjamin Harrell & Patrick Button & David Schwegman & E Dils, 2020. "Gender Identity, Race, and Ethnicity-based Discrimination in Access to Mental Health Care: Evidence from an Audit Correspondence Field Experiment," NBER Working Papers 28164, National Bureau of Economic Research, Inc.
    5. Halla, Martin & Kah, Christopher & Sausgruber, Rupert, 2021. "Testing for Ethnic Discrimination in Outpatient Health Care: Evidence from a Field Experiment in Germany," Department of Economics Working Paper Series 319, WU Vienna University of Economics and Business.
    6. Omry Yoresh & Weijian Zou, 2026. "The lifecycle of judicial bias," IFS Working Papers W26/12, Institute for Fiscal Studies.
    7. Silvia Angerer & Hanna Brosch & Daniela Glätzle-Rützler & Philipp Lergetporer & Thomas Rittmansberger, 2024. "Discrimination in the general population," Munich Papers in Political Economy 35, Munich School of Politics and Public Policy and the School of Management at the Technical University of Munich.
    8. Rita Ginja & Julie Riise & Barton Willage & Alexander L.P. Willén, 2022. "Does Your Doctor Matter? Doctor Quality and Patient Outcomes," CESifo Working Paper Series 9788, CESifo.
    9. Black, Nicole & Johnston, David W. & Shields, Michael A. & Trinh, Trong-Anh, 2024. "Inequity in Child Mental Healthcare Use," IZA Discussion Papers 17409, IZA Network @ LISER.
    10. Currie, Janet & Kurdyak, Paul & Zhang, Jonathan, 2024. "Socioeconomic status and access to mental health care: The case of psychiatric medications for children in Ontario Canada," Journal of Health Economics, Elsevier, vol. 93(C).
    11. Martin Beraja & Noam Yuchtman, 2025. "Generalized Disruption: Society, Work, and Property Rights in the Age of AI," NBER Chapters, in: The Political Economy of Artificial Intelligence, National Bureau of Economic Research, Inc.
    12. Angerer, Silvia & Zhuravleva, Tatyana, 2024. "Early childhood discrimination: A comparison of countries," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 113(C).
    13. Sandoval, Héctor & Hancevic, Pedro & Bejarano, Hernán, 2026. "Opportunistic behavior and discrimination in the mexican solar photovoltaic market: An audit experiment," World Development, Elsevier, vol. 197(C).
    14. Wolfgang Frimmel & Felix Glaser, 2024. "Socio-Economic Inequality in Mortality and Healthcare Utilization: Evidence from Cancer Patients," Economics working papers 2024-14, Department of Economics, Johannes Kepler University Linz, Austria.
    15. Sylvain Chareyron & Yannick L’Horty & Pascale Petit, 2023. "Cream skimming and discrimination in access to medical care: A field experiment," Health Economics, John Wiley & Sons, Ltd., vol. 32(8), pages 1868-1883, August.
    16. Anders Anell & Margareta Dackehag & Jens Dietrichson & Lina Maria Ellegård & Gustav Kjellsson, 2025. "Better off by risk adjustment? Socioeconomic disparities in care utilization in Sweden following a payment reform," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 44(3), pages 836-868, June.
    17. Aparajita Dasgupta, 2023. "Gender-Based Discrimination in Health: Evidence from Cross-Country," Springer Books, in: Ashwini Deshpande (ed.), Handbook on Economics of Discrimination and Affirmative Action, chapter 28, pages 649-665, Springer.

    More about this item

    Keywords

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    JEL classification:

    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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