IDEAS home Printed from https://ideas.repec.org/a/aea/apandp/v110y2020p284-88.html
   My bibliography  Save this article

Time Dependency in Physician Decision-Making

Author

Listed:
  • Lawrence Jin
  • Rui Tang
  • Han Ye
  • Junjian Yi
  • Songfa Zhong

Abstract

Using data on more than 250,000 emergency department (ED) visits, we study the time-of-day effect on physician decision-making and patient outcomes. After controlling for patient characteristics, physician fixed effects, and work hours, we find that cases treated at night have significantly lower probability of inpatient admission and involve fewer medical tests. These cases are also more likely to revisit the ED, which supports the decline in physician performance. While we cannot completely rule out the possibility of limited hospital arrangements, our findings are most consistent with the detrimental effect of disrupted circadian rhythms during night shifts.

Suggested Citation

  • Lawrence Jin & Rui Tang & Han Ye & Junjian Yi & Songfa Zhong, 2020. "Time Dependency in Physician Decision-Making," AEA Papers and Proceedings, American Economic Association, vol. 110, pages 284-288, May.
  • Handle: RePEc:aea:apandp:v:110:y:2020:p:284-88
    DOI: 10.1257/pandp.20201033
    as

    Download full text from publisher

    File URL: https://www.aeaweb.org/doi/10.1257/pandp.20201033
    Download Restriction: no

    File URL: https://doi.org/10.3886/E120761V1
    Download Restriction: no

    File URL: https://www.aeaweb.org/doi/10.1257/pandp.20201033.appx
    Download Restriction: no

    File URL: https://www.aeaweb.org/doi/10.1257/pandp.20201033.ds
    Download Restriction: Access to full text is restricted to AEA members and institutional subscribers.

    File URL: https://libkey.io/10.1257/pandp.20201033?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. David C. Chan, 2018. "The Efficiency of Slacking off: Evidence From the Emergency Department," Econometrica, Econometric Society, vol. 86(3), pages 997-1030, May.
    2. David C. Chan, 2016. "Teamwork and Moral Hazard: Evidence from the Emergency Department," Journal of Political Economy, University of Chicago Press, vol. 124(3), pages 734-770.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Marina Di Giacomo & Massimiliano Piacenza & Luca Salmasi & Gilberto Turati, 2024. "Understanding productivity in maternity wards," DISCE - Working Papers del Dipartimento di Economia e Finanza def134, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    2. Matthew C. Harris & Yinan Liu & Ian McCarthy, 2020. "Capacity constraints and time allocation in public health clinics," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 324-336, March.
    3. Matthew C. Harris & Yinan Liu & Ian McCarthy, 2019. "Capacity Constraints and the Provision of Public Services: The Case of Workers in Public Health Clinics," NBER Working Papers 25706, National Bureau of Economic Research, Inc.
    4. Rachet-Jacquet, Laurie & Gutacker, Nils & Siciliani, Luigi, 2021. "Scale economies in the health sector: The effect of hospital volume on health gains from hip replacement surgery," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 704-729.
    5. Labanca, Claudio & Pozzoli, Dario, 2022. "Hours Constraints and Wage Differentials across Firms," IZA Discussion Papers 14992, Institute of Labor Economics (IZA).
    6. Graff, Frederik & Grund, Christian & Harbring, Christine, 2021. "Competing on the Holodeck - The effect of virtual peers and heterogeneity in dynamic tournaments," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 90(C).
    7. Maria R. Ibanez & Michael W. Toffel, 2020. "How Scheduling Can Bias Quality Assessment: Evidence from Food-Safety Inspections," Management Science, INFORMS, vol. 66(6), pages 2396-2416, June.
    8. Fadlon, Itzik & Van Parys, Jessica, 2020. "Primary care physician practice styles and patient care: Evidence from physician exits in Medicare," Journal of Health Economics, Elsevier, vol. 71(C).
    9. David C. Chan, 2018. "The Efficiency of Slacking off: Evidence From the Emergency Department," Econometrica, Econometric Society, vol. 86(3), pages 997-1030, May.
    10. Saravanan Kesavan & Susan J. Lambert & Joan C. Williams & Pradeep K. Pendem, 2022. "Doing Well by Doing Good: Improving Retail Store Performance with Responsible Scheduling Practices at the Gap, Inc," Management Science, INFORMS, vol. 68(11), pages 7818-7836, November.
    11. Staněk, Rostislav & Krčál, Ondřej & Čellárová, Katarína, 2022. "Pull yourself up by your bootstraps: Identifying procedural preferences against helping others in the presence of moral hazard," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 98(C).
    12. Elena Lucchese, 2024. "How important are delays in treatment for health outcomes? The case of ambulance response time and cardiovascular events," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 652-673, April.
    13. Bruno Martins & Luís Filipe, 2020. "Doctors' response to queues: Evidence from a Portuguese emergency department," Health Economics, John Wiley & Sons, Ltd., vol. 29(2), pages 123-137, February.
    14. Zhou, Ke & Vidyarthi, Arpana & Matchar, David & Cheung, Yin Bun & Lam, Shao Wei & Ong, Marcus, 2018. "The relationship between workload and length of stay in Singapore," Health Policy, Elsevier, vol. 122(7), pages 769-774.
    15. Ben Weidmann & David J. Deming, 2020. "Team Players: How Social Skills Improve Group Performance," NBER Working Papers 27071, National Bureau of Economic Research, Inc.
    16. Gianni De Fraja & Jesse Matheson & James Rockey, 2020. "Zoomshock: The geography and local labour market consequences of working from home," Discussion Papers 20-31, Department of Economics, University of Birmingham.
    17. Moscelli, G.; & Sayli, M.; & Blanden, J.; & Mello, M.; & Castro-Pires, H.; & Bojke, C.;, 2023. "Non-monetary interventions, workforce retention and hospital quality: evidence from the English NHS," Health, Econometrics and Data Group (HEDG) Working Papers 23/13, HEDG, c/o Department of Economics, University of York.
    18. Jeffrey P. Clemens & Jonathan M. Leganza & Alex Masucci, 2021. "Plugging Gaps in Payment Systems: Evidence from the Take-Up of New Medicare Billing Codes," CESifo Working Paper Series 9209, CESifo.
    19. Emilio Bisetti & Benjamin Tengelsen & Ariel Zetlin‐Jones, 2022. "Moral Hazard In Remote Teams," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(4), pages 1595-1623, November.
    20. Freedman, Seth & Golberstein, Ezra & Huang, Tsan-Yao & Satin, David J. & Smith, Laura Barrie, 2021. "Docs with their eyes on the clock? The effect of time pressures on primary care productivity," Journal of Health Economics, Elsevier, vol. 77(C).

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:aea:apandp:v:110:y:2020:p:284-88. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Michael P. Albert (email available below). General contact details of provider: https://edirc.repec.org/data/aeaaaea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.