IDEAS home Printed from https://ideas.repec.org/a/bla/popmgt/v31y2022i6p2664-2680.html
   My bibliography  Save this article

How does workload affect test ordering behavior of physicians? An empirical investigation

Author

Listed:
  • Büşra Ergün‐Şahin
  • Evrim Didem Güneş
  • Ayşe Kocabıyıkoğlu
  • Ahmet Keskin

Abstract

We study the relationship between workload and the test ordering behavior of physicians in an operational context where examination can be finished with a test order. We define workload in two forms: the unfinished workload, that is, the work waiting to be completed, and the finished workload, that is, the already completed work since the beginning of the work day. We investigate their effect on the probability of a test order and the number of tests ordered for a patient who receives a test order. Empirical analysis of data from a public research and training hospital shows that these workload measures have different effects: A higher unfinished workload increases the probability of giving a test order, while a higher finished load decreases the number of tests ordered for those patients who receive a test order. The observed effects of the operational factors workload and finished load, which have no relation to the patients' complaints and hence, should have no bearing on the eventual diagnosis, and have significant implications for the quality and cost of health care. We also observe that the control variable, examination time, has a significant negative effect on the likelihood of ordering and the number of tests. We report the results of several robustness tests, which confirm our results.

Suggested Citation

  • Büşra Ergün‐Şahin & Evrim Didem Güneş & Ayşe Kocabıyıkoğlu & Ahmet Keskin, 2022. "How does workload affect test ordering behavior of physicians? An empirical investigation," Production and Operations Management, Production and Operations Management Society, vol. 31(6), pages 2664-2680, June.
  • Handle: RePEc:bla:popmgt:v:31:y:2022:i:6:p:2664-2680
    DOI: 10.1111/poms.13711
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/poms.13711
    Download Restriction: no

    File URL: https://libkey.io/10.1111/poms.13711?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. Hummy Song & Anita L. Tucker & Karen L. Murrell & David R. Vinsonc, 2018. "Closing the Productivity Gap: Improving Worker Productivity Through Public Relative Performance Feedback and Validation of Best Practices," Management Science, INFORMS, vol. 64(6), pages 2628-2649, June.
    2. Tom Fangyun Tan & Serguei Netessine, 2014. "When Does the Devil Make Work? An Empirical Study of the Impact of Workload on Worker Productivity," Management Science, INFORMS, vol. 60(6), pages 1574-1593, June.
    3. Robert J. Batt & Christian Terwiesch, 2017. "Early Task Initiation and Other Load-Adaptive Mechanisms in the Emergency Department," Management Science, INFORMS, vol. 63(11), pages 3531-3551, November.
    4. David C. Chan, 2018. "The Efficiency of Slacking off: Evidence From the Emergency Department," Econometrica, Econometric Society, vol. 86(3), pages 997-1030, May.
    5. Kenneth L. Schultz & David C. Juran & John W. Boudreau & John O. McClain & L. Joseph Thomas, 1998. "Modeling and Worker Motivation in JIT Production Systems," Management Science, INFORMS, vol. 44(12-Part-1), pages 1595-1607, December.
    6. Tinglong Dai & Shubhranshu Singh, 2020. "Conspicuous by Its Absence: Diagnostic Expert Testing Under Uncertainty," Marketing Science, INFORMS, vol. 39(3), pages 540-563, May.
    7. Saed Alizamir & Francis de Véricourt & Peng Sun, 2013. "Diagnostic Accuracy Under Congestion," Management Science, INFORMS, vol. 59(1), pages 157-171, December.
    8. Delasay, Mohammad & Ingolfsson, Armann & Kolfal, Bora & Schultz, Kenneth, 2019. "Load effect on service times," European Journal of Operational Research, Elsevier, vol. 279(3), pages 673-686.
    9. Leemore S. Dafny, 2005. "How Do Hospitals Respond to Price Changes?," American Economic Review, American Economic Association, vol. 95(5), pages 1525-1547, December.
    10. Cragg, John G, 1971. "Some Statistical Models for Limited Dependent Variables with Application to the Demand for Durable Goods," Econometrica, Econometric Society, vol. 39(5), pages 829-844, September.
    11. 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.
    12. Silverman, Elaine & Skinner, Jonathan, 2004. "Medicare upcoding and hospital ownership," Journal of Health Economics, Elsevier, vol. 23(2), pages 369-389, March.
    13. Michael Freeman & Nicos Savva & Stefan Scholtes, 2017. "Gatekeepers at Work: An Empirical Analysis of a Maternity Unit," Management Science, INFORMS, vol. 63(10), pages 3147-3167, October.
    14. Tinglong Dai & Mustafa Akan & Sridhar Tayur, 2017. "Imaging Room and Beyond: The Underlying Economics Behind Physicians’ Test-Ordering Behavior in Outpatient Services," Manufacturing & Service Operations Management, INFORMS, vol. 19(1), pages 99-113, February.
    15. Ludwig Kuntz & Roman Mennicken & Stefan Scholtes, 2015. "Stress on the Ward: Evidence of Safety Tipping Points in Hospitals," Management Science, INFORMS, vol. 61(4), pages 754-771, April.
    16. Sarang Deo & Aditya Jain, 2019. "Slow First, Fast Later: Temporal Speed‐Up in Service Episodes of Finite Duration," Production and Operations Management, Production and Operations Management Society, vol. 28(5), pages 1061-1081, May.
    17. Jillian A. Berry Jaeker & Anita L. Tucker, 2017. "Past the Point of Speeding Up: The Negative Effects of Workload Saturation on Efficiency and Patient Severity," Management Science, INFORMS, vol. 63(4), pages 1042-1062, April.
    18. Rogelio Oliva & John D. Sterman, 2001. "Cutting Corners and Working Overtime: Quality Erosion in the Service Industry," Management Science, INFORMS, vol. 47(7), pages 894-914, July.
    19. Diwas Singh KC & Christian Terwiesch, 2012. "An Econometric Analysis of Patient Flows in the Cardiac Intensive Care Unit," Manufacturing & Service Operations Management, INFORMS, vol. 14(1), pages 50-65, January.
    20. Tinglong Dai & Mustafa Akan & Sridhar Tayur, 2017. "Imaging Room and Beyond: The Underlying Economics Behind Physicians’ Test-Ordering Behavior in Outpatient Services," Manufacturing & Service Operations Management, INFORMS, vol. 19(1), pages 99-113, February.
    21. Diwas S. Kc & Christian Terwiesch, 2009. "Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations," Management Science, INFORMS, vol. 55(9), pages 1486-1498, September.
    22. Lauren F. Laker & Craig M. Froehle & Jaime B. Windeler & Christopher John Lindsell, 2018. "Quality and Efficiency of the Clinical Decision‐Making Process: Information Overload and Emphasis Framing," Production and Operations Management, Production and Operations Management Society, vol. 27(12), pages 2213-2225, December.
    23. Adam Powell & Sergei Savin & Nicos Savva, 2012. "Physician Workload and Hospital Reimbursement: Overworked Physicians Generate Less Revenue per Patient," Manufacturing & Service Operations Management, INFORMS, vol. 14(4), pages 512-528, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sun, Mingyao & Chai, Qiangfei & Ng, Chi To, 2023. "Managing the quality-speed tradeoff in blockchain-supported healthcare diagnostic services," Omega, Elsevier, vol. 120(C).

    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. Mirko Kremer & Francis de Véricourt, 2022. "Mismanaging diagnostic accuracy under congestion," ESMT Research Working Papers ESMT-22-01, ESMT European School of Management and Technology.
    2. Michael Freeman & Nicos Savva & Stefan Scholtes, 2017. "Gatekeepers at Work: An Empirical Analysis of a Maternity Unit," Management Science, INFORMS, vol. 63(10), pages 3147-3167, October.
    3. Robert J. Batt & Christian Terwiesch, 2017. "Early Task Initiation and Other Load-Adaptive Mechanisms in the Emergency Department," Management Science, INFORMS, vol. 63(11), pages 3531-3551, November.
    4. Diwas S. KC & Bradley R. Staats & Maryam Kouchaki & Francesca Gino, 2020. "Task Selection and Workload: A Focus on Completing Easy Tasks Hurts Performance," Management Science, INFORMS, vol. 66(10), pages 4397-4416, October.
    5. Delasay, Mohammad & Ingolfsson, Armann & Kolfal, Bora & Schultz, Kenneth, 2019. "Load effect on service times," European Journal of Operational Research, Elsevier, vol. 279(3), pages 673-686.
    6. Tom Fangyun Tan & Serguei Netessine, 2014. "When Does the Devil Make Work? An Empirical Study of the Impact of Workload on Worker Productivity," Management Science, INFORMS, vol. 60(6), pages 1574-1593, June.
    7. Maria R. Ibanez & Jonathan R. Clark & Robert S. Huckman & Bradley R. Staats, 2018. "Discretionary Task Ordering: Queue Management in Radiological Services," Management Science, INFORMS, vol. 64(9), pages 4389-4407, September.
    8. Tinglong Dai & Sridhar Tayur, 2020. "OM Forum—Healthcare Operations Management: A Snapshot of Emerging Research," Manufacturing & Service Operations Management, INFORMS, vol. 22(5), pages 869-887, September.
    9. Michael Freeman & Susan Robinson & Stefan Scholtes, 2021. "Gatekeeping, Fast and Slow: An Empirical Study of Referral Errors in the Emergency Department," Management Science, INFORMS, vol. 67(7), pages 4209-4232, July.
    10. Ann P. Bartel & Carri W. Chan & Song-Hee Kim, 2020. "Should Hospitals Keep Their Patients Longer? The Role of Inpatient Care in Reducing Postdischarge Mortality," Management Science, INFORMS, vol. 66(6), pages 2326-2346, June.
    11. Ludwig Kuntz & Roman Mennicken & Stefan Scholtes, 2015. "Stress on the Ward: Evidence of Safety Tipping Points in Hospitals," Management Science, INFORMS, vol. 61(4), pages 754-771, April.
    12. Farzad Zaerpour & Marco Bijvank & Huiyin Ouyang & Zhankun Sun, 2022. "Scheduling of Physicians with Time‐Varying Productivity Levels in Emergency Departments," Production and Operations Management, Production and Operations Management Society, vol. 31(2), pages 645-667, February.
    13. Carri W. Chan & Linda V. Green & Suparerk Lekwijit & Lijian Lu & Gabriel Escobar, 2019. "Assessing the Impact of Service Level When Customer Needs Are Uncertain: An Empirical Investigation of Hospital Step-Down Units," Management Science, INFORMS, vol. 65(2), pages 751-775, February.
    14. Mohammad Delasay & Armann Ingolfsson & Bora Kolfal, 2016. "Modeling Load and Overwork Effects in Queueing Systems with Adaptive Service Rates," Operations Research, INFORMS, vol. 64(4), pages 867-885, August.
    15. Zeynep Akşin & Sarang Deo & Jónas Oddur Jónasson & Kamalini Ramdas, 2021. "Learning from Many: Partner Exposure and Team Familiarity in Fluid Teams," Management Science, INFORMS, vol. 67(2), pages 854-874, February.
    16. Jillian A. Berry Jaeker & Anita L. Tucker, 2017. "Past the Point of Speeding Up: The Negative Effects of Workload Saturation on Efficiency and Patient Severity," Management Science, INFORMS, vol. 63(4), pages 1042-1062, April.
    17. Yuqian Xu & Tom Fangyun Tan & Serguei Netessine, 2022. "The Impact of Workload on Operational Risk: Evidence from a Commercial Bank," Management Science, INFORMS, vol. 68(4), pages 2668-2693, April.
    18. Ahmad M. Ashkanani & Benjamin B. Dunford & Kevin J. Mumford, 2022. "Impact of Motivation and Workload on Service Time Components: An Empirical Analysis of Call Center Operations," Management Science, INFORMS, vol. 68(9), pages 6697-6715, September.
    19. Diwas Singh KC, 2014. "Does Multitasking Improve Performance? Evidence from the Emergency Department," Manufacturing & Service Operations Management, INFORMS, vol. 16(2), pages 168-183, May.
    20. Hummy Song & Anita L. Tucker & Ryan Graue & Sarah Moravick & Julius J. Yang, 2020. "Capacity Pooling in Hospitals: The Hidden Consequences of Off-Service Placement," Management Science, INFORMS, vol. 66(9), pages 3825-3842, September.

    More about this item

    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:bla:popmgt:v:31:y:2022:i:6:p:2664-2680. 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: Wiley Content Delivery (email available below). General contact details of provider: http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1937-5956 .

    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.