Health Care Management Papers

Document Type

Journal Article

Date of this Version

3-2011

Publication Source

Journal of Health Economics

Volume

30

Issue

2

Start Page

381

Last Page

391

DOI

10.1016/j.jhealeco.2010.11.007

Abstract

Little is known about the ability of incentives to influence decisions by physicians regarding choices of settings for care delivery. In the context of outpatient procedural care, the emergence of freestanding ambulatory surgery centers (ASCs) as alternatives to hospital-based outpatient departments (HOPDs) creates a unique opportunity to study this question. We advance a model where physicians’ division of labor between ASCs and HOPDs affects the medical complexity of patients treated in low-acuity settings (i.e. ASCs). Analyses of outpatient surgical procedure data show that physicians working exclusively in low-acuity settings (i.e. ASCs) treat patients of significantly higher medical complexity in these settings than do physicians who also practice in higher-acuity settings (i.e. HOPDs). This discrepancy shrinks with increasing procedural risk and with increasing distance between ASCs and acute care hospitals.

Copyright/Permission Statement

© 2010 Elsevier B.V. All rights reserved.

Keywords

outpatient care, patient selection, physician behavior

Share

COinS
 

Date Posted: 27 November 2017

This document has been peer reviewed.