Discontinuity in care: Practice closures among primary care providers and patient health care utilization

• DOI: 10.1016/j.jhealeco.2021.102551
• Publication Date: 2021-11-01T16:15:46Z
• Authors: Marianne Simonsen; Lars Skipper; Niels Skipper; Peter Rønø Thingholm
• Keywords: Regression discontinuity design

We evaluate the consequences for patients of being matched to a new primary care provider due to practice closures. Using an event study and population-level data of patients and providers in Denmark, we find that the transition between providers is smooth; among re-matched patients, there is little change in primary care utilization at the extensive margin. Second, we document a 17% increase in fee-for-service per visit and a large increase in the probability that the patient initiates drug therapy targeting chronic and underdiagnosed diseases (hypertension, hyperlipidemia, and diabetes). Additionally, the re-matched patients are more likely to be admitted to inpatient care for these diseases. The increase in therapeutic initiation is not primarily because the new providers are relatively predisposed to prescribing these drugs. Instead, it appears that when patients match to new providers, there is a consequential reassessment of patients' medical needs which leads to the initiation of new treatment.