Identifying Provider Prejudice in Healthcare

Amitabh Chandra and Doug Staiger

No 16382, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: We use simple economic insights to develop a framework for distinguishing between prejudice and statistical discrimination using observational data. We focus our inquiry on the enormous literature in healthcare where treatment disparities by race and gender are not explained by access, preferences, or severity. But treatment disparities, by themselves, cannot distinguish between two competing views of provider behavior. Physicians may consciously or unconsciously withhold treatment from minority groups despite similar benefits (prejudice) or because race and gender are associated with lower benefit from treatment (statistical discrimination). We demonstrate that these two views can only be distinguished using data on patient outcomes: for patients with the same propensity to be treated, prejudice implies a higher return from treatment for treated minorities, while statistical discrimination implies that returns are equalized. Using data on heart attack treatments, we do not find empirical support for prejudice-based explanations. Despite receiving less treatment, women and blacks receive slightly lower benefits from treatment, perhaps due to higher stroke risk, delays in seeking care, and providers over-treating minorities due to equity and liability concerns.

JEL-codes: I12 J15 J16 J71 (search for similar items in EconPapers)
Date: 2010-09
Note: AG EH LS
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (19)

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