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Docs with their eyes on the clock? The effect of time pressures on primary care productivity

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  • Freedman, Seth
  • Golberstein, Ezra
  • Huang, Tsan-Yao
  • Satin, David J.
  • Smith, Laura Barrie

Abstract

This paper examines how time pressure, an important constraint faced by medical care providers, affects productivity in primary care. We generate empirical predictions by incorporating time pressure into a model of physician behavior by Tai-Seale and McGuire (2012). We use data from the electronic health records of a large integrated delivery system and leverage unexpected schedule changes as variation in time pressure. We find that greater time pressure reduces the number of diagnoses recorded during a visit and increases both scheduled and unscheduled follow-up care. We also find some evidence of increased low-value care, decreased preventive care, and decreased opioid prescribing.

Suggested Citation

  • 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).
    • Handle: RePEc:eee:jhecon:v:77:y:2021:i:c:s0167629621000278
    DOI: 10.1016/j.jhealeco.2021.102442
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    References listed on IDEAS

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    Cited by:

    1. Facchini, Gabriel, 2022. "Low staffing in the maternity ward: Keep calm and call the surgeon," Journal of Economic Behavior & Organization, Elsevier, vol. 197(C), pages 370-394.
    2. Leive, Adam & David, Guy & Candon, Molly, 2023. "On resource allocation in health care: The case of concierge medicine," Journal of Health Economics, Elsevier, vol. 90(C).
    3. Ity Shurtz & Alon Eizenberg & Adi Alkalay & Amnon Lahad, 2022. "Physician workload and treatment choice: the case of primary care," RAND Journal of Economics, RAND Corporation, vol. 53(4), pages 763-791, December.
    4. Berden, Carolien & Kuyterink, Magdalena & Mikkers, Misja, 2023. "Beyond the Clock : Exploring the Causal Relationship between General Practitioner Time Allocation and Hospital Referrals," Discussion Paper 2023-019, Tilburg University, Center for Economic Research.
    5. Berden, Carolien & Kuyterink, Magdalena & Mikkers, Misja, 2023. "Beyond the Clock : Exploring the Causal Relationship between General Practitioner Time Allocation and Hospital Referrals," Other publications TiSEM d0e5aecf-efc6-4658-a044-e, Tilburg University, School of Economics and Management.
    6. Chodick, Gabriel & Goldstein, Yoav & Shurtz, Ity & Zeltzer, Dan, 2022. "Challenging Encounters and Within-Physician Practice Variability," IZA Discussion Papers 15441, Institute of Labor Economics (IZA).
    7. Alquezar-Yus, M.;, 2023. "Time Constraints and the Quality of Physician Care," Health, Econometrics and Data Group (HEDG) Working Papers 23/06, HEDG, c/o Department of Economics, University of York.

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