Disruption in Primary Care and Patient Outcomes: Evidence From Physician Retirement

Xuan Zhang , Brown University

Most of the evidence linking primary care use with better patient outcomes is correlational in nature. In this paper, I exploit exogenous timing of primary care physician (PCP) retirement to study the causal effect of disruption in primary care on patients' health care utilization, medical costs, and health outcomes. I find that the disruption results in higher total medical costs and worsen patient health outcomes through the reduction in primary care utilization and discontinuity of care. Although on average patients find a new PCP of higher quality, this does offset the negative effect driven by the above-mentioned two channels. After the disruption, patients substitute primary care with more expensive specialty care and emergency care, and they use more diagnostic and imaging tests. Although there is no change in mortality, hospitalization increases due to the disruption.

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 Presented in Session 6. Health & Mortality & Aging