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Geographic Variation in Healthcare Utilization: The Role of Physicians

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  • Ivan Badinski
  • Amy Finkelstein
  • Matthew Gentzkow
  • Peter Hull

Abstract

We study the role of physicians in driving geographic variation of US healthcare utilization. We estimate a model that separates variation in average utilization of Medicare beneficiaries due to physicians, non-physician supply side factors, and patient demand. The model is identified by migration of patients and physicians across areas, as well as by variation in within-area matching. We find that physicians vary greatly in the intensity with which they treat otherwise similar patients, and that at least a third of geographic differences in healthcare utilization can be explained by differences in average physician treatment intensity. Conservatively, physicians are three times as important as non-physician supply-side factors in explaining geographic variation. Around three-fifths of physicians’ role comes from differences across areas in physician practice styles within the same specialty, while the other two-fifths reflects differences across areas in physician specialty mix.

Suggested Citation

  • Ivan Badinski & Amy Finkelstein & Matthew Gentzkow & Peter Hull, 2023. "Geographic Variation in Healthcare Utilization: The Role of Physicians," NBER Working Papers 31749, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:31749
    Note: AG EH LS
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    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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