Physician Practice Style and Patient Health Outcomes: The Case of Heart Attacks

Janet Currie, W. Bentley MacLeod, Jessica Van Parys

NBER Working Paper No. 21218
Issued in May 2015, Revised in February 2016
NBER Program(s):Health Care, Health Economics, Labor Studies

When a patient arrives at the Emergency Room with acute myocardial infarction (AMI), the provider on duty must quickly decide how aggressively the patient should be treated. Using Florida data on all such patients from 1992-2014, we decompose practice style into two components: The provider’s probability of conducting invasive procedures on the average patient (which we characterize as aggressiveness), and the responsiveness of the choice of procedure to the patient’s characteristics. We show that within hospitals and years, patients with more aggressive providers have consistently higher costs and better outcomes. Since all patients benefit from higher utilization of invasive procedures, targeting procedure use to the most appropriate patients benefits these patients at the expense of the less appropriate patients. We also find that the most aggressive and responsive physicians are young, male, and trained in top 20 schools.

Acknowledgments

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Document Object Identifier (DOI): 10.3386/w21218

Published: Janet Currie, W. Bentley MacLeod, Jessica Van Parys, Provider practice style and patient health outcomes: The case of heart attacks, Journal of Health Economics, Volume 47, 2016, Pages 64-80, ISSN 0167-6296, https://doi.org/10.1016/j.jhealeco.2016.01.013.