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

Author

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  • 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:

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    2. 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.
    3. 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.
    4. Patrick Button & Eva Dils & Benjamin Harrell & Luca Fumarco & David Schwegman, 2020. "Gender Identity, Race, and Ethnicity Discrimination in Access to Mental Health Care: Preliminary Evidence from a Multi-Wave Audit Field Experiment," NBER Working Papers 28164, National Bureau of Economic Research, Inc.

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    More about this item

    Keywords

    access to health care; SES health gradient; discrimination; field experiment;
    All these keywords.

    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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