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The effects of physician retirement on patient outcomes: Anticipation and disruption

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  • Zhang, Xuan

Abstract

The physician retirement rate in the United States is increasing as the population ages. I use an event study model allowing for anticipation to evaluate the effects of primary care physician (PCP) retirement on elderly adults’ health care utilization and quality of care. I find that, despite moderate anticipatory effects, PCP retirement results in an approximately $572 increase in total Medicare costs per beneficiary in the first 1.5 years post-retirement and an over 10% increase in detection of new chronic conditions. Heterogeneity analyses show that the increase in costs is disproportionately driven by the retirement of solo practitioners; Medicare beneficiaries with a retired PCP practicing in states with mandatory physician departure notice experience less disruption in care; and beneficiaries living in primary care health professional shortage areas experience greater disruption in care.

Suggested Citation

  • Zhang, Xuan, 2022. "The effects of physician retirement on patient outcomes: Anticipation and disruption," Journal of Public Economics, Elsevier, vol. 207(C).
  • Handle: RePEc:eee:pubeco:v:207:y:2022:i:c:s0047272722000056
    DOI: 10.1016/j.jpubeco.2022.104603
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    as
    1. Thomas J. Kane & Douglas O. Staiger, 2008. "Estimating Teacher Impacts on Student Achievement: An Experimental Evaluation," NBER Working Papers 14607, National Bureau of Economic Research, Inc.
    2. Jacobson, Louis S & LaLonde, Robert J & Sullivan, Daniel G, 1993. "Earnings Losses of Displaced Workers," American Economic Review, American Economic Association, vol. 83(4), pages 685-709, September.
    3. Louis S. Jacobson & Robert J. LaLonde & Daniel G. Sullivan, 1993. "Long-term earnings losses of high-seniority displaced workers," Economic Perspectives, Federal Reserve Bank of Chicago, vol. 17(Nov), pages 2-20.
    4. Manasi Deshpande & Yue Li, 2019. "Who Is Screened Out? Application Costs and the Targeting of Disability Programs," American Economic Journal: Economic Policy, American Economic Association, vol. 11(4), pages 213-248, November.
    5. 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).
    6. Cathy J. Bradley & David Neumark & Lauryn Saxe Walker, 2017. "The Effect of Primary Care Visits on Health Care Utilization: Findings from a Randomized Controlled Trial," NBER Working Papers 24100, National Bureau of Economic Research, Inc.
    7. Raj Chetty & John N. Friedman & Jonah E. Rockoff, 2014. "Measuring the Impacts of Teachers I: Evaluating Bias in Teacher Value-Added Estimates," American Economic Review, American Economic Association, vol. 104(9), pages 2593-2632, September.
    8. Tamara Bischof & Boris Kaiser, 2021. "Who cares when you close down? The effects of primary care practice closures on patients," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2004-2025, September.
    9. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    10. Weiss, L.J. & Blustein, J., 1996. "Faithful patients: The effect of long-term physician-patient relationships on the costs and use of health care by older Americans," American Journal of Public Health, American Public Health Association, vol. 86(12), pages 1742-1747.
    11. 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.
    12. Amy Finkelstein & Matthew Gentzkow & Heidi Williams, 2016. "Sources of Geographic Variation in Health Care: Evidence From PatientMigration," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(4), pages 1681-1726.
    13. David Molitor, 2018. "The Evolution of Physician Practice Styles: Evidence from Cardiologist Migration," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 326-356, February.
    14. Jeffrey Clemens & Joshua D. Gottlieb, 2014. "Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?," American Economic Review, American Economic Association, vol. 104(4), pages 1320-1349, April.
    15. Brekke, Kurt R. & Holmås, Tor Helge & Monstad, Karin & Straume, Odd Rune, 2017. "Do treatment decisions depend on physicians' financial incentives?," Journal of Public Economics, Elsevier, vol. 155(C), pages 74-92.
    16. Heather Lyu & Tim Xu & Daniel Brotman & Brandan Mayer-Blackwell & Michol Cooper & Michael Daniel & Elizabeth C Wick & Vikas Saini & Shannon Brownlee & Martin A Makary, 2017. "Overtreatment in the United States," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-11, September.
    17. Agha, Leila & Frandsen, Brigham & Rebitzer, James B., 2019. "Fragmented division of labor and healthcare costs: Evidence from moves across regions," Journal of Public Economics, Elsevier, vol. 169(C), pages 144-159.
    18. Simonsen, Marianne & Skipper, Lars & Skipper, Niels & Thingholm, Peter Rønø, 2021. "Discontinuity in care: Practice closures among primary care providers and patient health care utilization," Journal of Health Economics, Elsevier, vol. 80(C).
    19. Gaynor, Martin & Pauly, Mark V, 1990. "Compensation and Productive Efficiency of Partnerships: Evidence from Medical Group Practice," Journal of Political Economy, University of Chicago Press, vol. 98(3), pages 544-573, June.
    20. Lisa C. DeFelice & W. David Bradford, 1997. "Relative inefficiencies in production between solo and group practice physicians," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 455-465, September.
    21. Nathaniel Hendren, 2017. "Knowledge of Future Job Loss and Implications for Unemployment Insurance," American Economic Review, American Economic Association, vol. 107(7), pages 1778-1823, July.
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    Cited by:

    1. Hjalmarsson, Linn & Kaiser, Boris & Bischof, Tamara, 2023. "The impact of physician exits in primary care: A study of practice handovers," Health Policy, Elsevier, vol. 135(C).
    2. Monsees, Daniel & Westphal, Matthias, 2024. "Disruptions in primary care: Can resigning GPs cause persistently negative health effects?," Ruhr Economic Papers 1082, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    3. Katrin Zocher, 2024. "Exiting primary care providers," Health Economics, John Wiley & Sons, Ltd., vol. 33(5), pages 1033-1054, May.
    4. Gerald J. Pruckner & Flora Stiftinger & Katrin Zocher, 2024. "When women take over: Physician gender and health care provision," Economics working papers 2024-04, Department of Economics, Johannes Kepler University Linz, Austria.
    5. Sabety, Adrienne, 2023. "The value of relationships in healthcare," Journal of Public Economics, Elsevier, vol. 225(C).

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    More about this item

    Keywords

    Medicare; Physician retirement; Health care utilization; Quality of care; Anticipatory effect;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped; Non-Labor Market Discrimination
    • J26 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Retirement; Retirement Policies

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