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Physician Competition and the Provision of Care: Evidence from Heart Attacks

Abe Dunn () and Adam Hale Shapiro
Additional contact information
Adam Hale Shapiro: Federal Reserve Bank of San Francisco adam.shapiro@sf.frb.org Author email: adam.shapiro@sf.frb.org

American Journal of Health Economics, 2018, vol. 4, issue 2, 226-261

Abstract: We study the impact of competition among physicians on service provision and patients' health outcomes for the US commercial market. We focus on cardiologists treating patients with a first-time heart attack treated in the emergency room. Physician concentration has a small but statistically significant effect on service utilization. Cardiologists in more concentrated markets perform more intensive procedures, particularly diagnostic procedures—services in which the procedure choice is more discretionary. Higher concentration leads to fewer readmissions but has no effect on mortality. These findings suggest that changes in organizational structure, such as a merger of physician groups, influence not only the negotiated prices of services, but also service provision.

Keywords: competition; quality; utilization; physician markets (search for similar items in EconPapers)
JEL-codes: I11 L11 L40 (search for similar items in EconPapers)
Date: 2018
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Journal Article: Physician Competition and the Provision of Care: Evidence from Heart Attacks (2018) Downloads
Working Paper: Physician competition and the provision of care: evidence from heart attacks (2015) Downloads
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