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患者分选与下游支出:来自一项信息披露项目的证据

Patient sorting and downstream spending: evidence from an information disclosure program
Journal of Health Economics · 2026 · Nicole Holz

中文摘要

选择能够以合理成本提供高质量医疗服务的医生,可以改善健康结局并减少医疗支出。我研究了一项根据质量与成本对医生进行分类的信息披露项目。我采用断点回归设计,发现质量与成本效益两项得分均较高的医生新增患者数量多38%,且年轻患者比年长患者反应更敏感。通过评估在医生退出后更换医生的患者的理赔数据,我发现中年患者在转向更高质量、更低成本的医生时,其支出下降幅度大于年轻患者。

Abstract

Choosing a physician who can deliver high-quality care at a reasonable cost can improve health outcomes and reduce spending on healthcare. I study a disclosure program that classifies physicians based on quality and cost. I use a regression discontinuity design and find that physicians who score higher on both quality and cost effectiveness see 38% more new patients, and that younger patients are more responsive than older patients. Evaluating claims of patients who switch physicians following physician exit, I find that middle-aged patients experience larger reductions in spending than younger patients when switching to higher-quality, lower-cost physicians.
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