Measuring Physician Quality: Evidence from Physician Availability

Abstract:

Measuring physician quality is fundamental to understanding healthcare productivity, yet attempts to estimate the types of physicians that improve survival can be confounded due to patient sorting. This paper aims to overcome this endogeneity problem by exploiting plausibly exogenous variation in the mix of physicians available to treat the patient on the particular date of an inpatient admission. One innovation is the use of 100% Medicare claims data to characterize the mix of physicians available including specialty training, medical school quality rankings, patient volume, sex, and years of experience. When heart failure patients enter the hospital when more cardiologists are available, patients receive more intensive treatments and are more likely to survive at one year. The results speak to the debate over the value of treatment intensity and specialists in particular.