American Economic Review · 2022 · David W. Chan、Yiqun Chen
中文摘要
本文研究执业护士（NPs）与医生这两类职业的生产率，二者承担相互重叠的任务，但在背景、培训和薪酬方面存在显著差异。利用退伍军人健康管理局急诊科将患者分配给执业护士或医生的准实验变异，我们发现，平均而言，执业护士比医生使用更多资源，且患者30天内可预防住院率更高。然而，执业护士与医生之间的绩效差异因病例复杂程度和严重程度而异。重要的是，每种职业内部的生产率差异甚至更大，导致两类职业的生产率分布之间存在大量重叠；在随机配对中，执业护士有38%的概率表现优于医生。(JEL I11, I18, J24, J44, M53)
Abstract
This paper studies the productivity of nurse practitioners (NPs) and physicians, two professions performing overlapping tasks but with starkly different backgrounds, training, and pay. Using quasi-experimental variation in patient assignment to NPs versus physicians in Veterans Health Administration emergency departments, we find that, on average, NPs use more resources and exhibit a higher 30-day preventable hospitalization rate than physicians. However, the NP-physician performance difference varies by case complexity and severity. Importantly, even larger productivity variation exists within each profession, leading to substantial overlap between the productivity distributions of the two professions; NPs outperform physicians in 38 percent of random pairs. (JEL I11, I18, J24, J44, M53)