Coordination, Switching Costs and the Division of Labor in General Medicine: An Economic Explanation for the Emergence of Hospitalists in the United States

David O. Meltzer and Jeanette W. Chung

No 16040, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: General medical care in the United States has historically been provided by physicians who care for their patients in both ambulatory and hospital settings. Care is now increasingly divided between physicians specializing in hospital care (hospitalists) and ambulatory-based care primary care physicians. We develop and find strong empirical support for a theoretical model of the division of labor in general medicine that views the use of hospitalists as balancing the costs of coordinating care across physicians in the hospitalist model against physicians' costs switching between ambulatory and hospital settings in the traditional model. Our findings suggest opportunities to improve care.

JEL-codes: I1 (search for similar items in EconPapers)
Date: 2010-05
Note: EH
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Citations: View citations in EconPapers (5)

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