American Economic Journal:
Economic Policy
ISSN 1945-7731 (Print) | ISSN 1945-774X (Online)
The Impact of Organizational Boundaries on Health Care Coordination and Utilization
American Economic Journal: Economic Policy
vol. 15,
no. 3, August 2023
(pp. 184–214)
Abstract
We measure organizational concentration—the distribution of a patient's health care across organizations—to examine how firm boundaries affect health care efficiency. First, when patients move to regions where outpatient visits are typically concentrated within a small set of firms, their health care utilization falls. Second, for patients whose primary care providers (PCPs) exit the market, switching to a PCP with 1 standard deviation higher organizational concentration reduces utilization by 21 percent. This finding is robust to controlling for the spread of health care across providers. Increases in organizational concentration predict improvements in diabetes care and are not associated with greater use of emergency department or inpatient care.Citation
Agha, Leila, Keith Marzilli Ericson, and Xiaoxi Zhao. 2023. "The Impact of Organizational Boundaries on Health Care Coordination and Utilization." American Economic Journal: Economic Policy, 15 (3): 184–214. DOI: 10.1257/pol.20200841Additional Materials
JEL Classification
- D22 Firm Behavior: Empirical Analysis
- D23 Organizational Behavior; Transaction Costs; Property Rights
- D24 Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
- I11 Analysis of Health Care Markets
- J14 Economics of the Elderly; Economics of the Handicapped; Non-labor Market Discrimination
- R32 Other Spatial Production and Pricing Analysis
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