Fragmented Division of Labor and Healthcare Costs: Evidence from Moves Across Regions / Leila Agha, Brigham Frandsen, James B. Rebitzer.

Format:

Book

Author/Creator:

Agha, Leila.

Contributor:

National Bureau of Economic Research.

Frandsen, Brigham.

Rebitzer, James B.

Series:

Working Paper Series (National Bureau of Economic Research) no. w23078.

NBER working paper series no. w23078

Language:

English

Physical Description:

1 online resource: illustrations (black and white);

Other Title:

Fragmented Division of Labor and Healthcare Costs

Place of Publication:

Cambridge, Mass. National Bureau of Economic Research 2017.

Summary:

Policies aiming to improve healthcare productivity often focus on reducing care fragmentation. Care fragmentation occurs when services are spread across many providers, potentially making coordination difficult. Using Medicare claims data, we analyze the effect of moving to a region with more fragmented care delivery. We find that 60% of regional variation in care fragmentation is independent of patients' individual demand for care and moving to a region with 1 SD higher fragmentation increases care utilization by 10%. When patients move to more fragmented regions, they increase their use of specialists and have fewer encounters with primary care physicians. More fragmented regions have more intensive care provision on many margins, including services sometimes associated with overutilization (hospitalizations, emergency department visits, repeat imaging studies) as well as services associated with high value care (vaccines, guideline concordant for diabetics).

Notes:

Print version record

January 2017.