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突破距离限制?数字时代的医疗服务提供

Defying Distance? The Provision of Medical Services in the Digital Age
American Economic Review · 2026 · Amanda Dahlstrand

中文摘要

数字平台降低了地理摩擦,使服务提供者与用户之间能够实现更好的匹配。我利用瑞典全国范围内患者与医生之间以时间为条件的随机分配,量化了在线医疗服务中的重新配置收益。将高风险患者与能有效减少急诊就诊的医生相匹配,可使此类就诊减少4.4%(标准误为1.3);重新配置还可使不符合指南的抗生素使用减少3.1%(标准误为1.4)。我发现,匹配中的权衡有限;医生之间的横向差异化以及患者需求的多样性,使多个结果能够同时得到改善。提高效率的重新配置也会影响公平性。研究结果凸显出:当地理约束被解除时,通过重新组织医疗服务,使服务提供者的异质性与患者需求相匹配,具有改善医疗服务的潜力。

Abstract

Digital platforms reduce geographic frictions, enabling better matching between service providers and users. I quantify reallocation gains in Swedish online health care, using nationwide time-conditional random assignment between patients and physicians. Matching high-risk patients with doctors effective at reducing Emergency Room visits lowers such visits by 4.4 percent (SE 1.3); reallocations also reduce Counter-Guideline antibiotics by 3.1 percent (1.4). I find limited trade-offs in matching; horizontal differentiation among doctors and varied patient needs allow improvement in multiple outcomes simultaneously. Efficiency-enhancing reallocations also affect equity. The findings highlight the potential for care reorganization aligning provider heterogeneity with patient needs when geographic constraints are lifted. (JEL C78, H51, I11, I13, I14, I18)
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