Consolidation of primary care physicians and its impact on healthcare utilization

Zhang, Jonathan; Chen, Yiwei; Einav, Liran; Levin, Jonathan; Bhattacharya, Jay

doi:10.1002/hec.4257

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…Column 1 of Table 3 shows there is no statistically significant difference in the probability of referring to surgeons that work in the same practice as the referring physician compared to surgeons in different practices. I next examine if the referring physicians who work in a solo practice respond differently than referring physicians who work in larger practices as the prior literature suggests that physician practice size impacts their patient healthcare utilization (Zhang et al., 2021). The number of physicians associated with a practice in each quarter is identified by calculating the number of unique physicians that filed claims using a given TIN.…”

Section: Resultsmentioning

confidence: 99%

Effect of patient death on referrals to cardiac specialists

Haye

2024

Health Economics

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In this paper, I examine how patient death affects referrals from referring physicians to cardiac surgeons. I use Medicare data to identify pairs of referring physicians and cardiac surgeons who experience a patient death after a major surgical procedure to examine how these events affect referrals. I construct counterfactuals for affected pairs using pairs that experience a patient death but five quarters in the future. I find that there is a significant decline in the number of referrals and probability of a referral from the referring physician to the cardiac surgeon after the patient's death.

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Section: Resultsmentioning

confidence: 99%

Effect of patient death on referrals to cardiac specialists

Haye

2024

Health Economics

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“…There are several possible reasons for the observed decrease. First, changes in health care delivery such as higher enrollment in capitated payment insurance plans ( 34 , 35 ), the implementation of health policy innovations such as accountable care organizations and value-based purchasing ( 36 , 37 ), and provider market consolidation ( 38 ) all may exert negative pressure on usage. Second, clinical advances may have led to decreased usage in certain respiratory conditions.…”

Section: Discussionmentioning

confidence: 99%

Health Care Spending on Respiratory Diseases in the United States, 1996–2016

Duan

Birger²,

et al. 2023

Am J Respir Crit Care Med

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Rationale Respiratory conditions account for a large proportion of health care spending in the United States. A full characterization of spending across multiple conditions and over time has not been performed. Objectives To estimate health care spending in the United States for 11 respiratory conditions from 1996 to 2016, providing detailed trends and an evaluation of factors associated with spending growth. Methods We extracted data from the Institute of Health Metrics and Evaluation’s Disease Expenditure Project Database, producing annual estimates in spending for 38 age and sex groups, 7 types of care, and 3 payer types. We performed a decomposition analysis to estimate the change in spending associated with changes in each of five factors (population growth, population aging, disease prevalence, service usage, and service price and intensity). Measurements and Main Results Total spending across all respiratory conditions in 2016 was $170.8 billion (95% confidence interval [CI], $164.2–179.2 billion), increasing by $71.7 billion (95% CI, $63.2–80.8 billion) from 1996. The respiratory conditions with the highest spending in 2016 were asthma and chronic obstructive pulmonary disease, contributing $35.5 billion (95% CI, $32.4–38.2 billion) and $34.3 billion (95% CI, $31.5–37.3 billion), respectively. Increasing service price and intensity were associated with 81.4% (95% CI, 70.3–93.0%) growth from 1996 to 2016. Conclusions U.S. spending on respiratory conditions is high, particularly for chronic conditions like asthma and chronic obstructive pulmonary disease. Our findings suggest that service price and intensity, particularly for pharmaceuticals, should be a key focus of attention for policymakers seeking to reduce health care spending growth.

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“…First, unlike previous studies on the influencing factors of PHC visits, we explored their indirect and direct effects, which clarified the mixed impact of current measures to promote primary care at PCIs. It included PCI infrastructure [ 61 ], financial compensation [ 62 ], combined community medical care and pension services, and personal health characteristics [ 63 ]. In particular, it supplements research into the role of combined services.…”

Section: Discussionmentioning

confidence: 99%

How to Make Primary Healthcare More Popular: Evidence from the Middle-Aged and Elderly in China

Fang

Yang

et al. 2022

Healthcare

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Since 2001, China has been an aging society; it is expected to become superaged by 2033. This rapid aging trend poses a challenge to the elderly regarding their pension services and healthcare. Primary healthcare has great potential for serving older adults in the community, yet it is not popular. This study used 1977 samples from the 2018 China Health and Retirement Longitudinal Study database to explore the use of outpatient services in primary care institutions among the middle-aged and elderly. Using a structural equations model, we constructed a framework to explore pathways leading to primary outpatient use. We discovered that the supply of primary health services had a significant direct and mediating effect on the utilization of primary outpatient services, and that community pension services may indirectly discourage it. In addition, the supply of primary health services has a suppressor effect between medical insurance and primary outpatient utilization. Health insurance directly promotes primary outpatient utilization, while the supply of primary care institutions suppresses the positive influence of medical insurance on the utilization of primary outpatient services. Therefore, community pension services should pay attention to differentiated services. Moreover, adjusting the coordinated development of medical insurance and the supply of primary healthcare could enhance the positive effects of medical insurance for outpatients.

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Consolidation of primary care physicians and its impact on healthcare utilization

Cited by 8 publications

References 15 publications

Effect of patient death on referrals to cardiac specialists

Effect of patient death on referrals to cardiac specialists

Health Care Spending on Respiratory Diseases in the United States, 1996–2016

How to Make Primary Healthcare More Popular: Evidence from the Middle-Aged and Elderly in China

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