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是什么导致了药品处方在地域上的差异?来自医生流动的证据

What Causes Geographic Variation in Drug Prescribing? Evidence from Physician Migration
The RAND Journal of Economics · 2026 · David Beheshti、Seth Neller

中文摘要

本文考察医生个体因素在解释联邦医疗保险D部分处方药支出显著差异中的重要性。通过追踪医生迁移前后的处方行为,我们发现迁移者的处方向其新所在地的平均水平收敛。然而,这种收敛远不完全,凸显了医生特异因素的重要性。总体而言,这些医生特异因素解释了处方药支出截面变异的约60%至70%,表明医生是造成这一变异的最重要的供给面决定因素之一。我们进一步探讨了这种部分收敛背后的几种潜在机制。

Abstract

ABSTRACT In this article, we examine the importance of individual physicians in explaining the significant variation in prescription drug spending in Medicare Part D. By tracking prescribing behavior before and after physician relocations, we find that movers' prescribing converges toward the average of their new location. However, this convergence is far from complete, highlighting the importance of idiosyncratic physician‐specific factors. Overall, these physician‐specific factors explain about 60 to 70 percent of the cross‐sectional variation in prescription drug spending, suggesting that physicians are one of the most important supply‐side determinants of this variation. We investigate several potential mechanisms behind this partial convergence.
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