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Coordination, Switching Costs and the Division of Labor in General Medicine: An Economic Explanation for the Emergence of Hospitalists in the United States

Author

Listed:
  • David O. Meltzer
  • Jeanette W. Chung

Abstract

General medical care in the United States has historically been provided by physicians who care for their patients in both ambulatory and hospital settings. Care is now increasingly divided between physicians specializing in hospital care (hospitalists) and ambulatory-based care primary care physicians. We develop and find strong empirical support for a theoretical model of the division of labor in general medicine that views the use of hospitalists as balancing the costs of coordinating care across physicians in the hospitalist model against physicians' costs switching between ambulatory and hospital settings in the traditional model. Our findings suggest opportunities to improve care.

Suggested Citation

  • David O. Meltzer & Jeanette W. Chung, 2010. "Coordination, Switching Costs and the Division of Labor in General Medicine: An Economic Explanation for the Emergence of Hospitalists in the United States," NBER Working Papers 16040, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:16040
    Note: EH
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    Cited by:

    1. Matthieu Cassou & Julien Mousquès & Carine Franc, 2020. "General practitioners’ income and activity: the impact of multi-professional group practice in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(9), pages 1295-1315, December.
    2. Böckerman, Petri & Laine, Liisa T. & Nurminen, Mikko & Saxell, Tanja, 2020. "Information Integration, Coordination Failures, and Quality of Prescribing," Working Papers 135, VATT Institute for Economic Research.
    3. James B. Rebitzer & Mark E. Votruba, 2011. "Organizational Economics and Physician Practices," NBER Working Papers 17535, National Bureau of Economic Research, Inc.
    4. Leila Agha & Keith Marzilli Ericson & Kimberley H. Geissler & James B. Rebitzer, 2018. "Team Formation and Performance: Evidence from Healthcare Referral Networks," NBER Working Papers 24338, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health

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