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Does Your Doctor Matter? Doctor Quality and Patient Outcomes

Rita Ginja, Julie Riise (), Barton Willage and Alexander Willén ()
Additional contact information
Julie Riise: University of Bergen
Alexander Willén: Norwegian School of Economics, CESifo, and UCLS

Authors registered in the RePEc Author Service: Alexander Willén ()

No 2022-016, Working Papers from Human Capital and Economic Opportunity Working Group

Abstract: We estimate doctor value-added and provide evidence on the distribution of physician quality in an entire country, combining rich population-wide register data with random assignment of patients to general practitioners (GPs). We show that there is substantial variation in the quality of physicians, as measured by patients' post-assignment mortality, in the primary care sector. Specifically, a one standard deviation increase in doctor quality is associated with a 12.2-percentage point decline in a patient's two-year mortality risk. While we find evidence of observable doctor characteristics and practice styles influencing a GP's value-added, a standard decomposition exercise reveals that most of the quality variation is driven by unobserved differences across doctors. Finally, we show that patients are unable to identify who the high-quality doctors are, and that patient-generated GP ratings are uncorrelated with GP value-added. Using a lower bound of the predicted value of an additional life year in Norway ($35,000), our results demonstrate that replacing the worst performing GPs (bottom 5 percent of the VA distribution) with GPs of average quality generates a social benefit of $27,417 per patient, $9.05 million per GP, or $934 million in total. At the same time, our results show that higher-quality GPs are associated with a lower per-patient cost.

Keywords: value-added; health behaviors; mortality rate (search for similar items in EconPapers)
JEL-codes: H75 I11 I14 J18 (search for similar items in EconPapers)
Date: 2022-06
New Economics Papers: this item is included in nep-eur and nep-lab
Note: ECI, M
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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http://humcap.uchicago.edu/RePEc/hka/wpaper/Ginja_ ... ur-doctor-matter.pdf First version, June 2022 (application/pdf)

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