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医生退休对患者结局的影响:预期与中断

The effects of physician retirement on patient outcomes: Anticipation and disruption
Journal of Public Economics · 2022 · Xuan Zhang

中文摘要

随着人口老龄化,美国医生的退休率正在上升。我使用一个允许预期效应的事件研究模型,评估了初级保健医生(PCP)退休对老年人医疗保健利用率和医疗质量的影响。我发现,尽管存在适度的预期效应,PCP退休仍导致退休后前1.5年内每位受益人的Medicare总成本增加约572美元,以及新慢性病检出率增加超10%。异质性分析表明,成本增加不成比例地由独立执业医生的退休所驱动;在强制要求医生离职通知的州执业的退休PCP对应的Medicare受益人经历的医疗中断较少;且居住在初级保健卫生专业人员短缺区的受益人经历的医疗中断更大。

Abstract

The physician retirement rate in the United States is increasing as the population ages. I use an event study model allowing for anticipation to evaluate the effects of primary care physician (PCP) retirement on elderly adults’ health care utilization and quality of care. I find that, despite moderate anticipatory effects, PCP retirement results in an approximately $572 increase in total Medicare costs per beneficiary in the first 1.5 years post-retirement and an over 10% increase in detection of new chronic conditions. Heterogeneity analyses show that the increase in costs is disproportionately driven by the retirement of solo practitioners; Medicare beneficiaries with a retired PCP practicing in states with mandatory physician departure notice experience less disruption in care; and beneficiaries living in primary care health professional shortage areas experience greater disruption in care.
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