Abstract Physicians, judges, teachers, and agents in many other settings differ systematically the decisions they make when faced with similar cases. Standard approaches to interpreting exploiting such differences assume arise solely from variation preferences. We develop an alternative framework that allows preferences diagnostic skill show both dimensions may be partially identified standard under quasi-random assignment. apply this study pneumonia diagnoses by radiologists. Diagnosis...

Background: Although many patient, physician, and payment predictors of adherence have been described, knowledge their relative strength overall ability to explain is limited. Objectives: To measure the contributions in explaining statins. Research Design: Retrospective cohort study using administrative data. Subjects: A total 14,257 patients insured by Horizon Blue Cross Shield New Jersey who were newly prescribed a statin cholesterol-lowering medication. Measures: Adherence medication was...

High costs and unsafe care are major challenges for U.S. hospitals. Two sources of raised adverse events in hospitals tests ordered by several different physicians. After reviewing rates these two occurrences simulating their costs, we estimated that 2004 alone, eliminating readily preventable would have resulted direct savings more than $16.6 billion (5.5 percent total inpatient costs). Eliminating redundant saved an additional $8 (2.7 percent). Addressing situations could generate to the...

I investigate how teamwork may reduce moral hazard by joint monitoring and management. study two organizational systems differing in the extent to which physicians mutually manage work: Physicians are assigned patients a "nurse-managed" system but divide between themselves "self-managed" system. The self-managed increases throughput productivity reducing "foot-dragging" hazard, prolong patient stays as expected future work increases. find evidence that same location have better information...

The Relative Value Scale Update Committee (RUC) of the American Medical Association plays a central role in determining physician reimbursement. RUC's and performance have been criticized but subjected to little empirical evaluation.

Work schedules play an important role in utilizing labor organizations.In this study of emergency department physicians shift work, induce two distortions: First, "slack off" by accepting fewer patients near end (EOS).Second, distort patient care, incurring higher costs as they spend less time on accepted EOS.Examining how these effects change with overlap reveals a tradeoff between the two.Within hour after normal work completion, are willing to hospital resources eight times more than...

We study public versus private provision of health care for veterans aged 65 and older who may receive provided by the US Department Veterans Affairs (VA) in hospitals financed Medicare. Utilizing ambulance design Doyle et al. (2015), we find that VA reduces 28-day mortality 46 percent (4.5 per centage points) these survival gains are persistent. The also spending 21 delivers strikingly different reported services relative to hospitals. suggestive evidence complementarities between...

<sec> <title>BACKGROUND</title> Telehealth is a potential tool to alleviate geographic cardiology specialist shortages, but there limited data regarding current telehealth use for common conditions, including atrial fibrillation (AF). </sec> <title>OBJECTIVE</title> We evaluated variation in primary care and clinics patients with incident AF the Veterans Health Administration (VA). <title>METHODS</title> constructed cohort of diagnoses made outpatient setting 1/2022-9/2023. included...

Critics of Massachusetts's health reform, a model for the Affordable Care Act, have argued that insurance expansion probably had negative spillover effect leading to worse outcomes among already insured patients, such as vulnerable Medicare patients. Using data from 2004 2009, we examined trends in preventable hospitalizations conditions uncontrolled hypertension and diabetes—markers access effective primary care—in Massachusetts compared control states. We found after hospitalization rates...

The purpose of this survey was to understand how the people Hong Kong perceive mental health, illness, patients and health facilities. In March 1994, a total 1,043 successful telephone interviews were conducted out 2,202 valid numbers. sample found be representative adult population in terms sex ratio, age structure, educational achievement economic status. It that majority very concerned about their health. Their knowledge on fairly good. attitudes towards facilities were, however, quite...

Objective To assess the impact of Massachusetts Health Reform ( MHR ) on access, quality, and costs outpatient care for already‐insured. Data Sources/Study Setting Medicare data from before (2006) after (2009) implementation. Study Design We performed a retrospective difference‐in‐differences analysis quantity visits, proportion quality metrics met, patients with ≥1 chronic disease in 2006 versus 2009. used remaining states New England as controls. Collection/Extraction Methods existing...

Abstract In setting prices for physician services, Medicare solicits input from a committee that evaluates proposals industry. The itself comprises members industry; we investigate whether this arrangement leads to regulatory capture with biased toward industry interests. We find increasing measure of affiliation between the and proposers by one standard deviation increases 10%. then evaluate employing as an intermediary may nonetheless be desirable, if greater allows extract information...

I study team decisions among physician trainees. Exploiting a discontinuity in roles across trainee tenure, find evidence that teams alter decision-making, concentrating influence the hands of senior also demonstrate little convergence variation effects despite intensive training. This general pattern on decision-making exists all types and settings examine. In analyses evaluating mechanisms behind this pattern, support for idea significant experiential learning occurs during training place...

Abstract Objective To measure and compare mortality outcomes between dually eligible veterans transported by ambulance to a Veterans Affairs hospital those non-Veterans hospital. Design Retrospective cohort study using data from medical charts administrative files. Setting Emergency visits 140 Veteran 2622 non-Veteran hospitals across 46 US states the District of Columbia in 2001-18. Participants National 583 248 (aged ≥65 years) enrolled both Health Administration Medicare programs, who...

Many U.S. states have legislated to allow nurse practitioners (NPs) independently prescribe drugs. Critics contend that these moves will adversely affect quality of care.To compare rates inappropriate prescribing among NPs and primary care physicians.Rates were calculated compared for 23 669 50 060 physicians who wrote prescriptions 100 or more patients per year, with adjustment practice experience, patient volume risk, clinical setting, state.29 had granted prescriptive authority by...

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One of the most challenging environments in health care is emergency department (ED) A key decision-maker that context triage nurses, who assess patient illness severity and influence wait times for medical attention. We gather novel data on process across 108 EDs, including times, nurse identities assessments, detailed information outcomes. Using quasi-random assignment to ED, we find a striking rate “inversions,” where patients are sicker based either ex ante or post outcomes scored as...

Substantial practice variation across physicians for seemingly similar patients remains an unresolved puzzle.This paper studies in training to explore the behavioral foundations of variation.A discontinuity formation teams reveals a large contribution relative experience size variation.Among same physician trainees, convergence towards common differs by environment, with more specialist-driven services.Rich trainee characteristics and histories, including styles prior supervising physicians,...

Expert decisions often deviate from evidence-based guidelines. If experts are unaware of guidelines, dissemination may improve outcomes. aware guidelines but continue to deviate, promoting stricter adherence has ambiguous effects on outcomes depending whether have information not in We study for anticoagulant use prevent strokes among atrial fibrillation patients. By text-mining physician notes, we identify when physicians start using After mentioning become more guideline-concordant,...

Work schedules play an important role in utilizing labor organizations.In this study of emergency department physicians shift work, induce two distortions: First, "slack off" by accepting fewer patients near end (EOS).Second, distort patient care, incurring higher costs as they spend less time on accepted EOS.Examining how these effects change with overlap reveals a tradeoff between the two.Within hour after normal work completion, are willing to hospital resources eight times more than...