Who cares when you close down? The effects of primary care practice closures on patients

Bischof, Tamara; Kaiser, Boris (2021). Who cares when you close down? The effects of primary care practice closures on patients. Health economics, 30(9), pp. 2004-2025. Wiley 10.1002/hec.4287

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This paper investigates the consequences that patients face when their regular general practitioner (GP) closes down her practice, typically due to retirement. We estimate the causal impact of closures on patients' utilization patterns, healthcare expenditures, hospitalizations, mortality, and health plan choices. Employing a difference-in-difference framework, we find that patients who experience a discontinuity of care persistently adjust their ambulatory utilization pattern by shifting visits away from GPs (−12%) toward specialists (+11%) and hospital outpatient facilities (+6%). In contrast, we find no evidence on adverse health effects as measured by hospitalizations and mortality. The impact on utilization is heterogeneous along several dimensions. In particular, we find geographic disparities between regions with high and low availability of primary care. We also observe that patients with chronic conditions substitute more strongly toward other providers. Our results have potential implications for health policy in at least two dimensions: first, practice closures lead to more fragmented care which may entail inefficiencies, and second, closures deteriorate access to primary care in regions with low physician density.

Item Type:

Journal Article (Original Article)

Division/Institute:

03 Faculty of Business, Economics and Social Sciences > Department of Economics

UniBE Contributor:

Bischof, Tamara

Subjects:

300 Social sciences, sociology & anthropology > 330 Economics

ISSN:

1057-9230

Publisher:

Wiley

Language:

English

Submitter:

Dino Collalti

Date Deposited:

28 Dec 2021 09:35

Last Modified:

05 Dec 2022 15:55

Publisher DOI:

10.1002/hec.4287

BORIS DOI:

10.48350/161769

URI:

https://boris.unibe.ch/id/eprint/161769

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