Hjalmarsson, Linn; Kaiser, Boris; Bischof, Tamara (2023). The impact of physician exits in primary care: A study of practice handovers. Health Policy, 135(104867), p. 104867. Elsevier 10.1016/j.healthpol.2023.104867
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Recent studies on physician exits suggest that general practitioners (GPs) have an important impact on health care utilization and costs, but the transmission channels - interpersonal dis- continuities of care, practice style differences and deterioration in access - are usually not clear. Our objective is to estimate the short-run and long-run impacts of switches in GPs on patients' health care utilization and costs, while all other factors of the health care setting remain the same. To do this, we collect data on handovers of primary care practices in Switzerland, occurring between 2007 and 2015. We link this data to rich insurance claims to construct a panel dataset of roughly 240,000 patients. Employing a difference-in-difference type framework, we find transitory increases in overall visits and costs, which are likely caused by the entering GP's initial re-assessment of patients' health care needs. Additionally, we find long-term increases in specialist health care utilization and ambulatory costs. The latter finding can be explained by changes in practice styles between the exiting GP and her successor, who is typically much younger and more likely to be female. In contrast to the literature on practice closures, we do not find evidence on reduced overall utilization rates. An important lesson for health policy is thus to preserve patients' access to care in the case of GP exits.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
03 Faculty of Business, Economics and Social Sciences > Department of Economics > Institute of Economics 03 Faculty of Business, Economics and Social Sciences > Department of Economics |
UniBE Contributor: |
Hjalmarsson, Linn Beatrice |
Subjects: |
300 Social sciences, sociology & anthropology > 330 Economics |
ISSN: |
0168-8510 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
13 Jul 2023 13:31 |
Last Modified: |
08 Aug 2023 00:18 |
Publisher DOI: |
10.1016/j.healthpol.2023.104867 |
PubMed ID: |
37437479 |
Uncontrolled Keywords: |
Continuity of care Health care costs Health care utilization Physician exits Physician practice styles Primary care |
BORIS DOI: |
10.48350/184734 |
URI: |
https://boris.unibe.ch/id/eprint/184734 |
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