Jinhu Li - Physician competition and low value health care: Evidence from primary care

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Jan Kabátek

j.kabatek@unimelb.edu.au

Melbourne Institute Brown Bag

Title: Physician competition and low value health care: Evidence from primary care.

Abstract: This paper examines the impact of competition on the quality of care provided by physicians. New data on 328,000 consultations with 3,280 GPs are used to examine if competition changes the provision of low value care, as defined by the Choosing Wisely campaign. We have rich data on GPs and patients and competition facing a GP is measured by the distance to other GPs. Small area (postcode) fixed effects are included in our model to allow for unobserved area-level factors affecting GP competition and quality. More competition reduces low value care by reducing the likelihood of antibiotic prescribing for upper respiratory tract infections, bronchitis (common coughs and colds), and urinary tract infections. However, competition also increases low value care by increasing the likelihood of imaging for low back pain and x-rays for bronchitis. The effects of competition on low value care are stronger for GPs facing fixed prices.

Presenter: Dr Jinhu Li, University of Melbourne

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