TY - JOUR
T1 - Discontinuity in care
T2 - Practice closures among primary care providers and patient health care utilization
AU - Simonsen, Marianne
AU - Skipper, Lars
AU - Skipper, Niels
AU - Thingholm, Peter Rønø
N1 - Publisher Copyright:
© 2021 Elsevier B.V.
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
KW - Disruption
KW - Physician practice closure
KW - Practice styles
UR - http://www.scopus.com/inward/record.url?scp=85119073544&partnerID=8YFLogxK
U2 - 10.1016/j.jhealeco.2021.102551
DO - 10.1016/j.jhealeco.2021.102551
M3 - Journal article
C2 - 34785433
AN - SCOPUS:85119073544
SN - 0167-6296
VL - 80
JO - Journal of Health Economics
JF - Journal of Health Economics
M1 - 102551
ER -